Why do I need primary healthcare coverage in Wheaton?
Due to the fact that students live and study at Wheaton College 8-9 months out of the year, a majority of their primary, routine, urgent, and emergency healthcare will occur during this time. Though students can seek care at SHS for primary and many urgent needs, continual and specialized care such as physical therapy, psychiatry or counseling will need to be found off campus and in the community.
Is it required for me to have health insurance?
A portion of the Affordable Care Act (ACA) mandates that all US citizens carry adequate health insurance or pay an income penalty. Health care in the US is extremely expensive and health insurance can decrease the full expense that an individual must pay to receive healthcare. It is not advisable for students to study at Wheaton College, another Wheaton campus or abroad without appropriate health insurance. Health insurance allows students to seek appropriate care without fear of difficult financial burden. Health insurance also decreases the threat of public health disease as individuals have access to care.
As a college student with no reportable income, you may be eligible for tax credits or subsidies on monthly premiums to help pay for the insurance. However, that option is available only if you buy a plan through the online program administered by the government. Each state is different as to if you qualify for a subsidy. You will need to review your state’s requirements. Some Wheaton College programs and departments will require you to show health insurance before you will be allowed to participate. Wheaton College strongly recommends all students to carry health insurance that sufficiently covers them in the State that they are studying.
Can I use Student Health Services regardless of what type of health insurance I have?
Student Health Services (SHS) provides a variety of primary healthcare services at low costs to currently enrolled students, regardless of the health insurance status. All services are billed to student's account. They are provided a statement in their CPO box for possible insurance reimbursement.
I am a visa holding student and will be studying at Wheaton College. Do I need to have health insurance?
Many countries, other than the US, have universal or social health care delivery systems. This means, in general, if you are citizen of that country you are automatically provided health insurance and hence healthcare in your home country. However, once you leave your country this health insurance will not be applicable to the country that you are traveling to. Thousands of students come to the United States every year to study at US colleges and universities. International students are deemed to be non-residents under US law and are not subject to the legislation of the ACA unless certain time limits have been exceeded. For example, international students in the United States under F, J, M and Q visas do not need ACA insurance for the first five years they are in the States. After five years the individual is deemed to be no longer exempt and must go through the process of categorization depending on the substantial presence test. Many students or other non-residents will continue to be classed as non-residents even after five years when they can prove they have stronger connections to their own country than to the United States. You will need to find special health insurance designed for your needs. You can view the Library of Resources page which will assist you in finding insurance while you studying in the US. Wheaton College provides a mandatory health insurance product for all F1 visa holding students.
I am a green card holder, am I eligible to qualify for the US marketplace insurance?
Yes, you are eligible to use the state or federal marketplace. You can learn more on the HealthCare.gov website.
What is the cheapest insurance that provides the best benefits?
There really is no cheap insurance. Insurance simply shifts costs to be paid by the individual up front (premium) or when healthcare is utilized (deductible). This means that the individual can either pay a set monthly premium that is higher and less deductible (out of pocket expense) or less in up front premium costs and more in deductible or out of pocket expenses. If the cost of the insurance is lower than other products, it is worthwhile to investigate why. Cheap health insurance is not beneficial to you when you truly need to be covered.
I have a pre-existing medical condition, can I choose any health insurance?
The ACA mandate stated that certain health insurance products must cover all pre-existing medical conditions at the time of enrollment. However, some short term insurance products are not ACA compliant and are not required by law to insure pre-existing conditions immediately. When you talk with an agent from the insurance company make sure to ask this crucial question of coverage for pre-existing conditions. Examples of pre-existing medical conditions are diabetes, autoimmune disorders, musculoskeletal injuries/illnesses mental health, prescriptions, or pregnancy.
What questions should I ask a health insurance company regarding their product so that I make sure I get the best insurance for my needs?
Every individual is different and you should take the time to understand your health, financial and travel needs. Some important questions to ask are:
- What is the monthly cost of this plan?
- What is the deductible? Is the deadline per illness/injury or for the full time period of purchase.
- What networks are in my community for this type of insurance?
- Does this plan comply with the ACA requirements to avoid the penalty?
- Does this plan cover pre-existing conditions? Pharmaceuticals? In and outpatient mental health needs?
- How do I track my claims?
- Will this insurance be valid if I travel nationally or overseas?
- Is there a limit on covered benefits?
- What are the benefits that are covered and at what percentage?
- How do I pay for an insurance plan? Ask the agent if you can pay by credit or debit card. Ask if you purchase 6 months versus 1 month will the price be reduced. Ask the agent about the frequency of payments for the plan.
I am traveling or studying abroad. Do I need health insurance as I am not in the US?
The simple answer is YES. All students studying or traveling abroad should carry health insurance that covers preventive care before you leave the US, routine care while you are overseas and then any follow up care that is needed when you return. The Global and Experiential Learning Department has specific requirements for students studying abroad.
I am studying abroad and Wheaton College told me that they will provide health insurance for me while I am overseas. Is this sufficient health insurance or do I need more?
The insurance that Wheaton College provides to student is only valid while you are studying/traveling abroad with a Wheaton College program. This insurance was design to assist students with acute illness or injuries only during the program dates. This insurance will not provide care after the program is complete, or in preparation for the study abroad experience. The accident and illness insurance does not cover for mental health care, post hospitalization care or air flight back into the country of study after evacuation.