2016-2017 Student Health Benefit Plan

The Affordable Care Act requires most people to have health care coverage that qualifies as “minimum essential coverage.” The Student Health Plan does provide minimum essential coverage. 

Student Health Services (SHS) is pleased to announce the benefits for 2016/2017 policy year are in accordance with the Minimum Essential Coverage (MEC) mandate under the Affordable Care Act (ACA). The Centers for Medicare & Medicaid Services (CMS) have determined the WUSM Student Health 2016 – 2017 coverage complies with substantially all the requirements of the Affordable Care Act.

The WUSM Student Health Services Benefits Plan equals or exceeds the level of coverage for student health plans under the ACA and satisfies the individual mandate (which requires that most individuals have health insurance).

The Student Health Benefit Plan is comparable to that of a high-end “Gold” Marketplace plan, so the student receives “Gold +” level coverage at a “Bronze” price. Please note that SHS does not appear as an option on the Marketplace because student plans are not listed on the exchanges and are not eligible for premium subsidies.

This plan will begin on August 1, 2016, for all full-time medical degree seeking students and enrolled spouses, domestic partners, and dependents. All students in this category will automatically be enrolled in the mandatory plan, and each of these students will continue to have the option to enroll their eligible spouses, domestic partners and dependents. The spouse and dependents enrollment period is based on your matriculation. Students can call (314) 362-2346 to see if their spouse or dependent can still get coverage for 2016-2017 due to life change like marriage, birth of a child, or losing other coverage.

Compared to most other coverage options, the SHS Student Health Plan is:

  • the only health plan specifically designed to meet the needs of WUSM students
  • not motivated by profit; we make it available to students because having comprehensive health benefits is so important.
  • administered at SHS and by utilizing the expert care of SHS providers for primary and preventive care, costs are kept as low as possible.

In addition, the Student Health Plan has low out-of-pocket expenses. This is important because plans with high deductibles can make members reluctant or financially unable to receive medical treatment due to the initial expense. In comparison, “Bronze” Marketplace plans are permitted to have deductibles as high as $6,600 for an individual plan and even some “Gold” Marketplace plans have deductibles of $2,000.

Less expensive plans may be available, but it is important to remember the advantages of the SHS Student Health Benefit Plan and not consider any plan based on premium cost alone.

In accordance with the requirements of the ACA, Student Health Services has prepared a detailed Summary of Benefits and Coverage (SBC). The SBC provides a description of covered benefits, cost-sharing provisions, coverage limitations, and coverage examples that illustrate the approximate out-of-pocket cost of care for certain medical conditions.