Navigating Health Insurance: Underlying the Importance of Maximizing Benefits by Staying In-Network for your International Students 

March 14th, 2024 by Sally McLeod

Educating international students on the United States healthcare system is no easy feat. The bottom line is that health insurance is a must and there’s no real way around it. Whether or not your institution has a group plan or allows students to purchase coverage on their own, familiarizing students with insurance terminology is key to helping them properly understand their health insurance plan, and most effectively utilizing it. In this blog, we’ll delve into the benefits of going in-network on a health insurance plan, and what avenues to explore for making this as easy as possible for your students. 

Cost Savings for Student Budgets:

Choosing in-network healthcare providers can significantly contribute to cost savings on a health insurance plan. In-network providers have negotiated rates with insurance companies, leading to lower copays, deductibles, and overall out-of-pocket expenses. By staying in-network, students can make the most of their health insurance coverage without putting additional strain on their finances. It is important to identify what plan network(s) your students are using and educate them on how to find providers that are in-network. Opening up communication with the on-campus health center is also crucial in supporting your students. Setting up effective cost saving processes when visiting the student health center, such as direct billing on a group plan network, or with other specific provider networks, can ease anxiety about seeking treatment.

Transparent and Predictable Expenses:

The unpredictability of healthcare costs can be a source of stress for international students, and unfortunately this takes place often after it’s too late. Emphasizing that in-network providers offer transparent and predictable expenses, allow students to budget for their healthcare needs more effectively. With agreed-upon rates and standardized cost-sharing arrangements, there are fewer surprises when it comes to medical bills for students and the institution. This financial predictability fosters a sense of control and allows students to have a more positive international student experience without the added worry of unexpected healthcare expenses.

Ease of Access and Convenience:

In-network providers are strategically selected to offer convenient access to healthcare services. From routine check-ups to specialized treatments, staying in-network ensures that students can easily access a wide range of healthcare options without unnecessary travel or inconvenience. It’s important to identify and share nearby walk-in clinics, urgent care centers, and hospitals that accept the plan network that students are using. This ease of access promotes regular health check-ups and timely medical attention, contributing to overall well-being.

Streamlined Administrative Processes:

Understanding and navigating the US healthcare system can be a daunting task for anyone, especially for international students coming from countries with socialized healthcare. In-network providers typically streamline the administrative processes associated with healthcare. This includes simplified claims procedures, as in-network providers often submit claims directly to the insurance company. Such efficiency minimizes paperwork, making it easier for students to manage their health insurance-related tasks alongside their academic responsibilities.

Comprehensive Coverage Tailored to Student Needs:

Health insurance plans that are selected should cater to the unique needs of international students, providing comprehensive coverage for a variety of healthcare services. Staying in-network ensures that students have access to a network of reputable healthcare professionals, including specialists who can address specific health concerns. Comprehensive coverage contributes to the holistic well-being of students, allowing them to focus on their studies and personal growth with peace of mind.

Educating international students on the intricacies of health insurance in the U.S is a necessary time investment for administrators, as it will benefit students financially and allow for an overall more positive experience throughout their stay. As students embark on their international experience, embracing these insights will empower them to prioritize their health and make the most of their health insurance plan.

Dental Insurance for International Students in 2024

March 1st, 2024 by Angela Perrilliat

In preparing to become an international student, it’s likely you’ve been warned about how expensive medical treatment can be in the United States including dental treatment. Your student health insurance plan may cover doctor visits and/or potential hospitalizations, but more than likely won’t cover your bills if you were to chip a tooth, get a cavity, or need a root canal. To add a bit of perspective, here are the average costs of dental treatments in the United States:

Routine Dental Care
Dental Examination$100-$175
Professional Dental Cleaning$75-$210
Dental Sealant$20-$50 per tooth
Root Canal Treatment$500-$1,500
Tooth Extraction$75-$220 per tooth

While you’re still trying to decide if dental insurance is a good investment, it’s important to understand how this type of coverage works in the United States and what your options are. 

Dental insurance is much more straightforward and specific than medical insurance and if you don’t have a dentist at all, you can choose from the dentists in the network and again have the option of a less expensive plan. Although dental insurance works a little like health insurance, the premiums are typically much lower. Most health insurance policies cover a hefty percentage of even large expenses once you’ve paid your deductible; but this is not the case with dental insurance, which usually follows a 100-80-50 coverage structure for in-network dentists.

We offer three different levels of coverage plans : Lite, Boost and Complete. They all offer 100% preventative coverage and a comprehensive amount starting from day 1 and increased coverage after one year. Plans are available in monthly payments, and they can start as soon as the next day of purchase. A minimum purchase of three months is required. As for cancellation of your plan, it can be canceled prior to the start date for a full refund and after the start date, it can be canceled at any time after 90 days of coverage.

In addition to dental insurance plans, you can also get dental discount options. Referred to as dental savings plans, these types of plans require you to pay an annual fee (usually very low cost) and then in turn, you receive about 10% – 60% discount on specific dental care at select dentists. One additional benefit with discount dental plans is that you’re able to purchase them in the event you need something specific done. 

So remember, dental visits in the U.S don’t come cheap and it’s always good to hope for the best but prepare for the worst! If you have any questions about dental plans please contact us, we’ll be happy to help.

New York Plan

January 11th, 2024 by Leslie Reynolds

ISI is proud to introduce our new specialized New York group insurance plan, carefully crafted to meet the unique needs of your international students in New York state at affordable prices.

This new plan, insured by Crum & Forster, is ideal for schools in New York who:

  • Are interested in a group plan for international students
  • Want an affordable plan that includes wellness, maternity, and mental health coverage
  • Are looking for more support with insurance, including a dedicated account manager, 24/7 multilingual support for students, and an easy-to-use enrollment system.

Many schools realize they are ready to move to a group plan when they want to require insurance but don’t want to chase students down for compliance verification. Having a group plan is an excellent way to ensure your students have the insurance coverage you know they need while also making the management process easier on you and your team.

Specifically, the ISI New York plan meets state requirements and includes excellent benefits such as:

  • $500,000 policy maximum
  • $150 deductible per injury/illness
  • Wellness covered 100%
  • Mental health coverage
  • Maternity coverage
  • Sports coverage up to principal available
  • Network: Aetna Passport

In addition, the plan is fully customizable and can be used as a launching pad for developing the perfect group plan for your population.

Rates begin at $84.63 per month (which includes $5,000 club and intramural sports coverage). For sports that include intercollegiate up to the principal sum, the rates begin at $128.03. Of course, the rates will change with customizations, but we are committed to working with you to find the benefits and the rates that work best for your students.

Want to learn more? Contact Leslie Reynolds today! 

Open Doors Report 2023

December 11th, 2023 by Leslie Reynolds

The Open Doors report, an annual collection of data from institutions around the United States, was recently released for 2023. Schools all around the country submit their numbers and figures for both incoming international students and scholars as well as outgoing study abroad participation from the previous year. The result is the robust and comprehensive Open Doors Report, which offers a snapshot of the state of international education in the US thanks to the committed participation of a large number of institutions. The survey is “sponsored by the US Department of State with funding provided by the U.S. Government and supported in its implementation by [the Institute for International Education] IIE.”

It’s important to note the reported timelines when reviewing Open Doors Data. For the 2023 Open Doors Report, the following time periods were reported on:

  • Fall 2022 total international student enrollment for the 2022-2023 academic year
  • Fall 2021-Summer 2022 study abroad participation

This year’s data shows that international education is beginning to recover from the decimating impact of COVID. While study abroad participation is not yet back to pre-COVID levels, there was a major increase from the previous reported year (Fall 2020-Summer 2021), with a 1,197% increase. Of course, this is due to the drastic decrease in participation in the height of COVID (2020-2021), so we anticipate this number continuing to increase and eventually surpass pre-COVID numbers within a few years. Prior to 2020, study abroad numbers were in the 300,000s; this year’s report, for 2021-2022, shows that 188,753 students studied abroad for academic credit. 

Meanwhile, the number of incoming international students, which is based on Fall 2022 enrollment, saw a nearly 12% increase from Fall 2021 with 1,057,188 reported international students. In the last reported year prior to COVID (2019-2020), there were 1,075,496 international students in the US. So, we are quickly returning to that high volume of international students, which has been steadily increasing since the 1960s.

In addition to overall numbers, the Open Doors Report also shows the top places of origin of international students and the top destinations for study abroad participants. This is helpful in understanding trends, preparing for student arrival, and understanding the student experience. 

The top 5 places of origin of international students for 2022-2023 are: China, India, South Korea, Canada, and Vietnam. Do these closely match your most popular places of origin for your international students, or does our population look quite different from this?

For study abroad participation, the top 5 destinations for 2021-2022 are: Italy, United Kingdom, Spain, France, and Germany. South Korea was the only country in Asia that appeared on the top 25 destinations list, but this will likely change as we get further out from the effects of the global pandemic. 

Overall, we at ISI are encouraged to see the numbers of international education participation increasing again after a tough couple of years. We are glad to see the entire world recovering from the global pandemic, and are eager to see more cultural exchange and educational experiences unfold as we all get back to a new normal.

For more information about the Open Doors Report, to review high level data, or to purchase the full report, please visit opendoorsdata.org.

International Education Week

November 7th, 2023 by Leslie Reynolds

International Education Week 2023 is November 13-17. This initiative is a collaboration between the US Department of State and the US Department of Education that began in 2000 under the Clinton administration. President Clinton issued an executive memorandum where he highlighted the United State’s commitment to cultural exchange through international education. The first IEW was celebrated later that year and has been a cornerstone program of ISSS and Education Abroad offices around the country ever since.

As international educators, we welcome the opportunity to highlight why it’s important to travel outside of your comfort zone, meet and interact with people from different countries, and explore cultures that are different from your own. Cultural exchange leads to cross cultural understanding, which helps to make our world a more peaceful and welcoming place. 

If you don’t have the means or ability to travel outside of the United States, that’s okay! Remember that there are thousands of international students on college campuses all over the country who are eager to share more of their culture with you. The US is a country of great diversity, and many different cultures and customs can be experienced without the need to get on a plane. In particular, on a college campus, you have access to lots of resources and programs that are designed to build your understanding of other cultures and countries. IEW is a week that showcases this type of event and will make them even more accessible to you, so be sure to find out how YOUR school is celebrating.

Each year, a theme is selected for IEW. This year’s theme is “International Education is the Future,” a strong statement about the importance and impact of cultural educational exchange. Within the overall theme, the departments also select a focus for each day. This year’s daily themes are: 

  • Open Doors to the Future
  • You are the Future!
  • The Future is Global
  • Innovate the Future
  • Lead the Future

While the Bureau of Educational & Cultural Affairs (a bureau of the State Department) offers these themes, the ways in which institutions choose to celebrate IEW can vary widely from year to year and from campus to campus. 

Examples of events that you might see on a college campus during IEW include:

  • Study Abroad information sessions or fairs
  • Speakers covering current global issues
  • Events highlighting post-graduate international opportunities such as Peace Corps and Fulbright
  • Opportunities for international students to share about their home country and culture
  • International festivals
  • Travel photo and video contests

To see how some of our partner schools are celebrating, click the links below. Then, comment to let us know what kind of events your college or university is hosting this year, and how you’re planning to participate!

https://today.troy.edu/news/international-education-week-2022/

https://www.rmc.edu/news/randolph-macon-celebrates-international-education-week/

https://isss.fiu.edu/events/international-education-week/

International Student Insurance Coverage for International Student Athletes

July 14th, 2023 by Leslie Reynolds

What type of sports insurance coverage do your international students need? Sports and athletic coverage can be a bit confusing when it comes to international student insurance, so let’s break it down!

Insurance plans typically use the following language to distinguish between types of sports coverage: intercollegiate sports, interscholastic sports, intramural sports, recreational sports, club sports, and adventure sports. 

Intercollegiate Sports

Intercollegiate sports refers to sports that are played for a college or university. In the US, these typically fall under the National Collegiate Athletic Association (NCAA), and often schools will have their own insurance plan that helps to cover NCAA athletes in the event of injury (during practice or a game). However, it is helpful to have students on a comprehensive private insurance plan in case something happens on or off the field (or court) and will help protect from losses on the school’s athletic policy.It’s important to check the policy wording to make sure that every sport the students are playing is covered – and always review the exclusions on a policy in full!

Interscholastic Sports

Typically, this term is going to refer to high school or middle school sports–NOT college sports. Not every plan will cover an organized school sport so be sure to confirm that your secondary students have interscholastic sports coverage included. You may also want to verify the area of coverage, especially if the team is involved in traveling.

Intramural Sports

Intramural sports are recreational organized sports and for the purpose of recreation and having fun. Oftentimes, intramural sports are run by student organizations and are more casual. However, students who plan to participate in intramural sports should have coverage for sports-related injuries. Again, it’s important to review policy wording to be sure coverage is in place for when something happens while participating in the sport.

Club Sports

Club sports are typically viewed as more competitive than intramural sports, but less competitive than intercollegiate sports. They often require tryouts and can be organized by different organizations on campus such as different schools on campus, fraternities/sororities, clubs/groups, etc. Students who participate in club sports are not necessarily considered “college athletes,” since they are not playing for the school, but they should have coverage for sports-related injuries. Club sports are sometimes separated out from intercollegiate and intramural sports so, once again, check policy wording carefully!

Recreational Sports

Recreational sports are sports that are participated in non-professionally and in a non-organized fashion. For example, a group of friends playing a pick up game of basketball. Or, a student playing racquetball at the local gym. These may or may not be covered based on the policy wording of the plan.

Adventure Sports

Adventure sports, also known as Extreme Sports, refers to the adrenaline-rush type of activities such as skydiving, bungee jumping, white water rafting, caving, cross-country skiing, or paragliding. These are often excluded from base plans, but in some cases can be included with an add-on. Be sure to check the policy wording for the list of extreme sports before students engage in those activities. Often, you will find more information about excluded sports by checking the exclusion section of the policy wording.

Know Your Policy

If you’re advising student athletes, know your policy and its fine print. Be able to communicate these details to your international students. If they have questions about the claims process when dealing with a sports-related injury, please have them contact the insurance for further clarification on how the plan works!

Why is Sports Coverage Important?

Sports injuries are inevitable. And, they can often snowball, requiring surgeries, physical therapy, braces, and other care that can add up quickly. Ensuring your students are properly covered in the event of an athletic injury is important for your student’s well being and the health of the athletic team. We never want to see students (or institutions) worry about how they are going to pay very expensive medical bills, and athletic injuries can sometimes result in costly medical bills. So make sure your student athletes are covered! 

For non-student athletes, it’s best to have a policy that covers intramural, recreational, and even club sports, since many students do choose to participate in these activities. Same as above, it would be awful to see a student wind up with piles of medical debt because they hurt themselves while playing a game with friends. 

If you ever have questions or need further guidance about athletic coverage for your students, please know our University Relations team is here to guide you and can help you find the best option for your population.

Dental and Vision Health Insurance Plans: A Great Supplement to Traditional Health Insurance for your International Students 

June 30th, 2023 by Sally McLeod

Whether you’re deciding on a group plan, or offering your international students different health insurance options, dental and vision health are often overlooked aspects of students’ needs. Many international student health insurance plans focus solely on their general health, but dental and vision has continued to be a requested benefit from many schools and students alike. Having the option for a dental and vision plan supplement for your students on a group or individual basis can create an even more all encompassing plan for your students, offering enhanced coverage and additional benefits. In this blog, we will explore the significance of dental and vision health insurance and some new options available to you and your students!

The Importance of Dental Health Insurance

Comprehensive Dental Coverage: Dental health insurance plans typically cover a wide range of preventive, restorative, and cosmetic dental procedures. From routine check-ups and cleanings to fillings, extractions, and even orthodontic treatments, having dental coverage ensures that you can maintain your oral health without worrying about the high costs of dental procedures.

Early Detection of Dental Issues: Regular dental check-ups can help detect oral health problems at an early stage when they are more manageable and less expensive to treat. Dental insurance encourages individuals to visit their dentists regularly, promoting preventive care and reducing the risk of developing more severe dental issues down the line.

Financial Protection: Dental procedures, especially major ones like root canals or dental implants, can be costly. Dental health insurance provides financial protection, helping individuals manage their dental expenses more effectively. By paying a monthly premium, students can gain peace of mind, knowing they have coverage for unexpected dental emergencies or planned treatments.

The Significance of Vision Health Insurance

Comprehensive Vision Care: Vision health insurance plans encompass a variety of services, including routine eye exams, prescription glasses or contact lenses, and even surgical procedures such as LASIK. With vision coverage, individuals can maintain their eye health and receive necessary vision correction, reducing the strain on their budget.

Early Detection of Eye Conditions: Regular eye exams play a crucial role in identifying potential eye diseases and conditions like glaucoma, cataracts, or macular degeneration. Timely diagnosis and treatment can help prevent or minimize the progression of these conditions, preserving one’s vision and overall quality of life.

Affordability of Eyewear: Prescription glasses or contact lenses can be quite expensive, especially for those with complex vision needs. Vision health insurance plans often offer discounts or allowances towards the purchase of eyewear, making it more affordable for individuals to access the corrective lenses they require.

The Benefits of Dental and Vision Health Insurance Plans

Holistic Approach to Healthcare: By incorporating dental and vision coverage into the overall health insurance strategy for your international students, you ensure that you are addressing additional aspects of their well-being. Good oral and vision health contribute significantly to one’s overall quality of life, and having separate insurance plans for these areas allows for comprehensive and focused care. 

Cost Savings: Dental and vision health insurance plans provide financial protection against unexpected expenses, enabling students to receive necessary treatments without facing exorbitant out-of-pocket costs. Routine preventive care covered by these plans can also help prevent more significant issues that may require costly interventions.

Access to Specialist Care: Dental and vision health insurance often allows for referrals to specialists when needed. This ensures that you have access to the expertise required for more complex dental or eye conditions, facilitating specialized treatments and improved outcomes.

Dental and vision health insurance plans are a great supplement to traditional health insurance for international students. By offering these types of plans, you can ensure that students’ dental and vision needs are met, promoting preventive care, earlier detection of issues, and financial protection. Our Dental and Vision plans come in various levels of coverage and can be purchased individually by students or added on as a supplement to your current group plan. These plans are available across the entire United States for international students and other foreign nationals living in the United States, in addition to US citizens and permanent residents. 

How to Help Your Students Find Discounts on Prescription Medication Costs

February 3rd, 2023 by Leah Hammond

After visiting a doctor, your students may be prescribed medication, and they may come to you with questions about how to get these medications from the pharmacy and the amount they need to pay out-of-pocket. If your students do not have a health insurance plan in place or if they need to pay for the medications upfront, students may be looking to minimize the amount they have to spend on prescription medications.

There may also be times when a medication isn’t covered under their plan – for example, if a student is taking medication that was prescribed to them before they arrive in the United States, this likely won’t be covered due to pre-existing condition limitations. They may also be prescribed medication that is related to a condition excluded from their plan, like contraceptives or medication for acne. 

In this blog, we’ll discuss different ways for students to find discounts on prescription medication costs, from discount drug cards, online cost comparison platforms, and pharmacy discount programs. We’ll offer suggestions on ways to receive discounts on non-covered medications, and we’ll also look at different options for discounts on birth control methods that would not normally be covered under an international health insurance plan. 

Discount Drug Programs

Students can utilize discount drug programs to reduce the out-of-pocket expense they would need to pay at the pharmacy, and they can also use these programs for prescription medication that may be related to a general exclusion of the plan that wouldn’t be covered. Below, we’ll look into some different options available to your students to help with the expenses associated with covered, and non-covered, prescription medications. 

Discount Pharmacy Cards

Most of the plans offered through ISI come with a discount prescription pharmacy card. This is not insurance coverage, but instead, is a discount card students can present at the pharmacy when picking up their prescription medication that offers a discount on the amount that needs to be paid out of pocket.

For example, our Student Secure plan includes the VantageAmerican Discount Pharmacy Card, which will offer an average savings of 5% to 15% off brand drugs and an average of 15% to 40% off the price of generic drugs. Once the discount is applied to the prescription, the remaining expenses can still be submitted to the insurance company for reimbursement as usual.

These cards sometimes include discounts on routine vision and dental services as well, which are not generally covered by international student health insurance plans, so the benefit of these kinds of discount programs goes beyond just prescription medication. These cards will be included in the policy fulfillment students receive when they purchase the plan, and if they have questions about these programs, they can contact our customer service team for more information. 

GoodRx 

GoodRx is an online platform that allows students to compare prices and find discounts on prescriptions being paid for without insurance coverage. By using GoodRx, students will be able to find the pharmacy in their area that has the lowest price for their prescription, and they can also find coupons that will provide a discount on the amount they need to pay out of pocket. Once the discount is applied, they will need to pay the remaining amount at the pharmacy, and can then submit a claim to their insurance company to be reimbursed per the plan’s benefits. 

Pharmacy Discount Programs 

Some pharmacies, like Publix and Walmart, offer certain prescriptions at a set price, making it more affordable for those who have to pay out of pocket for their medication. 

For example, Publix offers certain maintenance medications, including Metformin, Lisinopril, and Amlodipine, for $7.50 for a 90-day supply, and antibiotics like Amoxicillin for $7.50 for a 14-day supply. You can view a full list of discounted medications offered through Publix here

Walmart offers a variety of 30-day medications for just $4.00, as well as some 90-day doses for just $10.00. You can view a list of discounted medications offered through Walmart here

CostPlus Drug Company

CostPlus is a great option for those who may have a condition that is not covered by their plan and need prescription medications for this condition. CostPlus charges the true cost of each medication – they cut out the pharmacy middleman and negotiate directly with the manufacturer to get the lowest price possible, and only charge a small administrative fee. 

CostPlus does require a prescription from a U.S.-based provider, so students would need to visit a doctor to get a prescription before they can take advantage of this service. If the condition at hand is excluded from their plan, they would be responsible for any costs associated with the visit, but they can then use CostPlus to keep their prescription expenses low moving forward.

Birth Control Options without Insurance

In the United States, birth control is only available with a prescription from a doctor. Contraception methods are commonly excluded by international student health insurance plans, which means the initial visit to the doctor and the prescription would not be covered. We understand access to birth control is important, and the good news is there are quite a few low-cost options available for students, both online and in-person, that will offer discounts on the costs associated with birth control prescriptions. 

Online

There are many online retailers that offer telehealth appointments with a doctor for birth control, and this can be a convenient way for students to get a prescription without having to pay for an in-person appointment. These platforms are a great option for those who don’t have insurance, and the prescription will be mailed directly to the student. Below you’ll find a few different options you can suggest to your students, but a quick Google search will provide you with a variety of different options available in your state. 

Nurx

Nurx offers various services, tests, and birth control ordering options. Options without insurance include the birth control pill starting at $15, the birth control shot ranging from $75 every 3 months, and the birth control patch starting at $180 per month. 

Hers

Hers includes a free initial medical consultation, with birth control options starting as low as $12 a month without insurance. 

SimpleHealth

SimpleHealth makes it easy with affordable birth control options, free delivery, automatic refills, and unlimited access to speak with a doctor without health insurance. 

In-Person

Some students may want to see a doctor in person before getting a prescription for birth control. Instead of making an appointment with a gynecologist, which would generally not be covered under their plan and could be expensive without insurance coverage, there are other low-cost options they can explore.

Planned Parenthood

Planned Parenthood works to make healthcare in the United States accessible and affordable. They offer wellness exams, birth control prescriptions, and STI testing at low costs, and some centers even charge based on income. Students can find a Planned Parenthood location near them online and can contact them to find out more about the costs associated with a visit and a birth control prescription. 

State Reproductive and Sexual Health Services

Different states around the country offer reproductive and sexual health services at low-cost, including comprehensive birth control options, pregnancy testing, STI testing and treatment, and reproductive cancer screenings. Students can find clinics that offer these services online here, and the cost of these services are based on each individual’s ability to pay. 

Discount Drug Programs

As mentioned earlier, there are quite a few discount drug programs students can utilize when paying for their prescription medications. These programs work for birth control prescriptions as well, so if a participant does visit a doctor for a birth control prescription, they can compare prices and look for the most affordable option through platforms like GoodRx and RxSaver.

At ISI, we believe prescription medication, whether covered or not through insurance, should be easily accessible for your students at affordable prices. If students come to you with questions about prescriptions, you can provide them with the different discount options we’ve discussed in this blog to ensure they’re aware of the different resources available to them to help keep the costs associated with their prescriptions as low as possible! If you have any questions about certain prescriptions or any of the discount programs mentioned above, please don’t hesitate to contact our customer service team at ISI and we’d be happy to help! 

Common Questions: Is the Affordable Care Act Suitable for International Students?

December 6th, 2022 by Jennifer Frankel

The Affordable Care Act – also referred to as ACA, Obamacare, or PPACA – has now been around for over a decade having been signed into law by former President Obama on March 23, 2010. The ACA required US citizens and permanent residents to maintain “minimum essential healthcare coverage” or be subject to pay a fine when paying taxes to the International Revenue Service (IRS). This fine has since been eliminated in many cases but it changed the landscape of the way that US insurance companies did and continue to do business.

While the initial intent of the bill was to expand coverage to US citizens, there were questions surrounding its impact on international students, scholars, and other populations. Now, having been in existence for a while, there is a lot of clarity about what school and student responsibilities are. In this blog, we will examine some popular questions regarding ACA coverage.

Does the ACA apply to international students?

If a student is holding an F, J, M, or Q visa in the U.S., they are considered a non-resident alien for tax purposes for the first 5 years and are exempt from the mandate. There is no insurance requirement for F1 students, and it is up to the school to determine what the requirements are.

Does the ACA apply to J visa holders similarly?

Similar to the requirement for F visa holders, any J visa holder who is a non-resident for tax purposes is also exempt from the ACA. But, unlike F1 visa holders who have no federal requirements, the Department of State does require that all J1 and J2 visa holders maintain a certain level of insurance requirements while in the US at all times (which is significantly less than what the ACA requires).

>>Learn the insurance requirements for J visa holders

How are schools navigating their group insurance plan for students?

Many schools throughout the US do require some level of health insurance; however that can vary by school. The most common ways to administer a school’s insurance plan includes:

  • A group plan just for international students (which may or may not include scholars)
  • A group plan for all students, including US and international students
  • No group plan, but may require all students to enroll in an individual plan that meets certain requirements

While the way in which insurance is administered can vary school by school, it is important that all international students carry some insurance while they are in the US. It can be challenging to explain how expensive the healthcare system in the US is and how there is no national or universal healthcare system. 

What does an ACA compliant plan mean?

An ACA compliant group plan is often found on college campuses when both domestic and international students are on one plan, but it doesn’t have to be. ACA coverage requires the plan to be filed in that state and to also meet the “minimum essential healthcare coverage”. The 10 benefit requirements are:

  1. Ambulatory patient services (outpatient care you get without being admitted to a hospital) 
  2. Emergency services
  3. Hospitalization (like surgery and overnight stays)
  4. Pregnancy, maternity, and newborn care (both before and after birth)
  5. Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  6. Prescription drugs 
  7. Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  8. Laboratory services 
  9. Preventive and wellness services and chronic disease management 
  10. Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

In addition to these 10 requirements, these plans are also required to include coverage for both birth control (https://www.healthcare.gov/coverage/birth-control-benefits/) and breastfeeding (https://www.healthcare.gov/coverage/breast-feeding-benefits/). These plans must also provide unlimited coverage, pre-existing coverage from day one, including wellness, and maternity must be covered the same as any other illness.

Due to rising costs, many schools have decided to look at alternate options since prices are on the rise and students struggle to afford to pay the high costs. And since international students and scholars don’t need ACA compliant coverage, schools have more flexibility to build a plan more in line with the needs of international students, both in terms of budget and benefits.

What does it mean if I don’t have an ACA compliant plan?

Many schools and students have been questioning how essential an ACA compliant plan is as the costs are often thousands and thousands of dollars every year. But schools may appreciate the comprehensive benefits an ACA plan might bring.

For plans that are not ACA, you can customize the plan specifically to meet the unique needs of your international student population (which may or may not include those essential benefits discussed above). This means you can still have unlimited coverage, if you think that’s appropriate – or you can have wellness included. However, you do not have to. By being able to customize your plan, you can get the benefits you want with more flexibility to customize the plan. 

What are the advantages of a non-ACA plan?

A non-ACA plan allows you to customize your insurance plan based on the benefits you need. Many times these carriers are more in tune with the unique needs of your student or scholar population and may also include:

  • Emergency medical evacuation – required on a J visa!
  • Repatriation of remains – required on a J visa!
  • Emergency reunion
  • 24-7 multilingual travel assistance

You will also find that these plans are much less expensive and have a lower out of pocket cost (the deductible, copays and coinsurance tend to be lower) when students use the plan.

It is important no matter the plan, that you understand what it does and doesn’t cover. Reviewing the master policy is essential to understanding your policy. Ask for it and do not rely solely on the brochure. Once reviewing this document, carefully review the exclusions to know what is and what isn’t covered. 

What questions should you ask about your insurance proposal?

If you are reviewing an insurance plan, it’s important to review the policy in full and know what it does and doesn’t cover. Questions you can ask include:

  • Provider Network – How much do you pay inside and outside the network? Are there providers nearby and what does the claim process look like?
  • Coverage Area – Where are my students covered (in the state, throughout the US, or outside the student’s home country?)?
  • Insurer – Who is insuring the plan and what is their rating by A.M. Best or Standard and Poor’s?
  • Claims – Where are the claims processed? How long should it take? Is there a way for students to follow up on their claim? Is it by reimbursement or will it be paid directly to the provider?
  • Benefits and Exclusions – Look through the policy and be sure to understand the benefits and exclusions to understand how your policy will be paying out claims. When in doubt, ask!

If you or your organization is looking at group plan options, our team would be happy to help provide you with a customized proposal for your school. To get started, please request a quote and our University Relations Team will be in touch with you shortly.

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