Affordable Ohio Health Insurance Plans

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As a condition for enrollment at Ohio State University (OSU), students are required to be covered under a qualified health insurance plan. This requirement applies to undergraduate students enrolled for six or more eligible credit hours (four or more eligible credit hours for graduate and professional students and three hours for post-candidacy students).

Audit, continuing education, non-degree, and “observe only” classes are not recognized as eligible classes. Distance learning classes are counted if regular classes are also taken. Automatic enrollment results with internships, thesis research, overseas study, and co-ops that are approved by OSU.

You may choose to purchase private on and off-Marketplace coverage or the OSU option. Anthem Blue Cross, Medical Mutual, Ambetter, CareSource, SummaCare, Oscar, Molina, and Paramount offer qualified guaranteed coverage including pediatric dental benefits. We assist students to make informed decisions when selecting a plan and/or opting out.

You can also be covered under a parent’s private or employer-provided plan until age 26. At that time, a “Special Enrollment” will allow you to select a Marketplace plan, regardless if the Open Enrollment period has ended. Pre-existing conditions will be covered and a federal subsidy may be available, depending on your household income. Multiple carriers are available in all counties in the state.

International Students

All international students must also meet these requirements, and are automatically enrolled in the “SHI Benefits” plan. Also, auto-enrolled are students that study overseas, interns, and persons working on dissertations or a thesis. Coverage can be waived if the government purchases a policy that meets specific requirements or the student has a green card.

However, if alternative qualified coverage is in-force, a waiver will be granted. If no selection is made, the comprehensive plan will automatically be selected. Generally, you must select a choice about seven days before August Semester classes begin. An online “Petition To Waive” is available for students that request an exemption.

When registering for classes for the first calendar year term, the Buckeye Link will indicate the cost of coverage for the comprehensive plan option. That coverage can be kept, or waived, with proof of another qualified policy. If waived, a supplementary WilceCare policy (discussed in detail later) also becomes available. NOTE: The annual period of coverage is August to August as opposed to using the calendar year.

Qualifying Events

If you miss the Enrollment/Select/Waive period for changes to the comprehensive plan, a 31-day period is granted if you qualify for a “qualifying event,” and submit the appropriate form to SHI. However, any form received after that period will not be considered. Coverage can be requested to be added or terminated. Examples are listed below:

Death of spouse, child, or dependent

Dependent no longer eligible for other coverage because of age restriction

Adding a spouse because of marriage

Deleting a dependent because of divorce

Dependent becomes US citizen

Adding a newborn from legal adoption or delivery

Dependent leaves country to return home

Employment change leads to new healthcare eligibility

Domestic partnership is terminated

Rates

2023 OSU student health insurance rates are listed below. These rates are “per semester” with the plan offered and underwritten by UnitedHealthcare, one of the nation’s largest healthcare providers. Details of the OSU student health insurance plan can be viewed through the provided link. NOTE: Although UHC has greatly reduced their presence on state and federal Exchanges, it does not impact the specific plans offered at OSU.

All of the options below satisfy ACA (Affordable Care Act) requirements and regulations, and include “minimum essential requirements.” Qualified preventative benefits require no out-of-pocket cost, and there is no annual or lifetime maximum benefit payable.

(Paid TWICE per year)

Student –   $1,765

Student And Spouse –   $3,530

Student And Child – $3,530

Student And Spouse And  Child –   $5,295

Student And Two Or More Children –   $5,295

Student And Spouse And Two Or More Children –   $7,060

Summer (Only)  Rates

Student –   $883

Student And Spouse –   $1,765

Student And Child – $1,765

Student And Spouse And  Child –   $2,648

Student And Two Or More Children –   $2,648

Student And Spouse And Two Or More Children –   $3,530

Plan Overview

The policy provides comprehensive healthcare benefits, including coverage for office visits, prescriptions, Urgent Care and ER visits, major medical, mental illness, dental, and vision. If network facilities are utilized, maximum out-of-pocket expenses will be minimized. However, the UnitedHealthcare network is also available for off-campus treatment.

Within the Franklin County PPO Network area, there are many available facilities. If purchased through the Federal Marketplace, the policy would closely resemble a Platinum-tier plan.  NOTE: Picture above is property of OSU.

Additional specific network highlights include a low $150 deductible ($350 per family) and $3,000 ($6,000 per family) maximum out-of-pocket costs (in-network treatment). Both primary-care physician (PCP) and specialist office visits  are subject to only a $20 copay with no limit on the number of covered visits.

Also, no referrals are required. Vision and dental exams also feature the $15 copay. Urgent Care visits are subject to a $25 copay (Tier 2). An ER visit will result in a $100 copay and 10% coinsurance. If admitted, the copay is waived. Note: Dental benefits are provided by Delta Dental.

The OSU Health Plan Network in Franklin County is a preferred provider in Tier 2. Outside of Franklin County, UnitedHealthcare Options PPO is utilized. Preferred provider level benefits are provided for emergency treatment.

“Tier 1” services are provided at the Wilce Student Health Center. By utilizing the facility, office visits, diagnostic lab tests and x-rays, allergy testing, treatment and injections, surgery, and outpatient procedures are covered at 100%. Also covered without any out-of-pocket expenses are durable medical equipment, and prosthetic devices.

The benefit package was recommended by the Student Health Insurance Advisory Committee and approved by the Board of Trustees. Counseling and consultation service (CCS) is included for students and covered dependents. Additional benefits include:

100% qualified preventative benefits with no out-of-pocket costs. Common examples annual well visit, immunizations and screenings required by OSU academic programs,breast cancer screening, and prostate cancer screening.

10% coinsurance for diagnostic tests (blood work and x-rays), MRIs, and PET/CT scans.

10% coinsurance for generic drugs, 20% for preferred brand drugs, and 50% for non-preferred brand drugs.

10% coinsurance for physician/surgeon and facility fees. 

10% coinsurance for injections and chemotherapy.

10% coinsurance and $100 copay for Emergency-Room visits.

10% coinsurance for hospice and rehabilitation services, skilled nursing care, and durable medical equipment.

$20 copay for outpatient office visits for substance abuse treatment and outpatient office visits for mental illness treatment.

Exclusions

Not all medical expenses are covered, regardless if treatment is performed in the Columbus area, or outside of Ohio. A partial listing of exclusions is listed below:

Experimental or unapproved surgery

Elective surgery or treatment 

Bariatric surgery

Cosmetic surgery and procedures

Hearing aids

Infertility treatment

Adult dental care

Weight loss programs

Long-term care

Foot care

Custodial care

Hearing aids

Hypnosis

Growth hormones

If you receive treatment at the Wilce Student Health Center, usually there will be very little (or no) out-of-pocket cost. Qualified preventative expenses are covered with no out-of-pocket cost. This also applies to the UnitedHealthcare-provided benefits (Tiers 2 and 3). Common examples include: routine annual physicals, prostrate and testicular screening, breast cancer screening, well-visits, OBGYN exams, and colorectal cancer screening.

WilceCare Supplement Plan Option

If you opt out of the “comprehensive” option, and choose to utilize your own private plan, depending on your deductible and network benefits, higher out-of-pocket expenses could result, depending on the number of submitted claims. The WilceCare option is a pre-paid coverage that provides benefits for common ailments (and injuries).  It is not a qualified insurance plan, and covered treatment must be provided at the Wilce Student Health Center during normal operating hours.

The two main components of the contract are prescription drugs and outpatient treatment. In-hospital expenses, or any services provided away from the Wilce Center are not covered.  The Buck ID is the only identification needed for treatment. Major highlights of the rider are listed below:

Annual cost is $225, the premium must be paid to the Bursar.  Spouses and dependents are not eligible for coverage.

$2,000 is the maximum amount of benefits paid for the contract year. Once the maximum has been reached, covered services would discontinue. Prescription drugs have a separate maximum of $225.

Outpatient services include office visits, physical therapy, allergy injections, diagnostic services, including x-rays, lab tests, and electrocardiograms, and needed supplies.

Prescription drugs for conditions that are covered under the program. Coinsurance is 10% for generic drugs, 20% for brand name drugs (no possible generic substitute offered), and 50% for brand name drugs with generic substitute available. A $10 copay also applies, unless the cost of the prescription is less.

Exclusions

The following conditions and expenses are excluded:

Dental and vision treatment, including glasses, contact lenses, and hearing aids.

Non-prescribed medications (over-the counter) and contraceptives.

Preventative treatment. NOTE: These types of expenses are 100% covered under private and group plans.

Psychotherapy and psychiatry.

Services not medically necessary for treatment or diagnosis of illness or injury.

Services not specified as a “covered service.”

Comparison Of OSU Student Plan To Available Private Plans

For our comparison, we are assuming the insured is a healthy 20 year-old  who lives in the Columbus area. It should be noted that rates vary, depending on where you live, your smoking status, and age. For this comparison, we did NOT include a federal subsidy, which can substantially lower premiums if you meet eligibility requirements. Listed below are some of the best plans to consider for student health coverage in Ohio. Rates are monthly:

$175 – Medical Mutual Market HMO Young Adult Essentials – $8,700 deductible with $40 copay for first three pcp office visits.

$192 – Oscar Select – $8,700 deductible with $0 copay for first three pcp office visits.

$205 – Anthem BCBS Catastrophic Pathway X HMO 8700   – $8,700 deductible with $40 copay for first three pcp office visits.

$234 – Oscar Bronze Simple – $8,000 deductible with $3 generic drug copay.

$235 – Oscar Bronze Classic – $7,500 deductible with $50 copay for first pcp office visit and $3 generic drug copay. 

$250 – Anthem Bronze Pathway X HMO Bronze – $8,700 deductible with 0% coinsurance.

$257 – Oscar Bronze Simple – HSA -$5,200 deductible with50% coinsurance. HSA-eligible.

There are many affordable student health insurance options and it’s very possible one of the plans listed above may be worth considering. Our contact information is listed at the top of the page and we are always available to discuss the best choices.

Summary

We continue to be recognized as the premier resource for all student medical coverage. You can view additional details here and view quotes live online. Often, purchasing your own private coverage is much less expensive and many benefits will be much more comprehensive. However, each situation is different so we’ll be happy to provide our unbiased advice and input.

It is also important to note that we are not affiliated with the OSU student health insurance program. However, optional  coverage from many top-rated companies is very comprehensive, and rates are quite attractive. Specific questions regarding OSU student plan rates, coverage, eligibility requirements and enrollment details should be directed to this website.  However, we also encourage comparing rates from all of the available carriers, not just one. Our quote section at the top of the page will help.