Looking for Health Insurance?

The following information is designed to assist you in the process of selecting a health insurance plan that meets your needs for coverage in your current stage of life.

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Considerations for Selecting a Health Insurance Plan

To begin selecting a health insurance plan, you will need to consider certain personal criteria such as

  • Home of Origin and Location of Study
  • Age
  • Marital and Family Status
  • Health Status
  • Financial Status

Home of Origin & Location of Study

Your permanent mailing address can affect what plan in which you are eligible to enroll. Benefits of the chosen plan must be applicable to all of the Wheaton College campus locations where you intend to live/study as a student.

For example, if your permanent mailing address is not in Illinois, it is important to select a plan that provides coverage in Illinois while you attend Wheaton College, Illinois. A Wheaton College post office box is not a valid address for insurance enrollment. If you are a student attending the main Wheaton Illinois campus and your permanent mailing address is in Illinois, you may be eligible to apply for the expanded State of Illinois Healthcare Coverage program.

If you are a visa holding international student with a permanent mailing address outside of the United States, there are optional special plans that are designed to meet your needs. For more information and links related to plans for international students please refer to the Library of Resources.

For domestic students, for short term plan enrollment, it is necessary to use the Wheaton College address so that the insurance is active while studying in Wheaton.

Age

Under the age of 26

You may be eligible to enroll in an employer group plan or a family plan through your parent(s.) Some plans only provide coverage through a certain network or for services in the home state of the primary subscriber. Carefully read what is covered by the plan when deciding to remain enrolled in a family plan. While you are a student, it is important that your plan provide coverage for emergency and non-emergency hospital services, urgent and sick visits, annual preventive exams, vaccines, mental health or behavioral services, diagnostic testing, and follow-up care for an injury including physical therapy where you are living. You may also be eligible to enroll in an individual plan through a private insurance company or through the Federal Marketplace. All of the plans through the Marketplace are Affordable Care Act Compliant and have provisions for the mandated Essential Health Benefits and no restrictions for pre-existing conditions.

Over the age of 26

You may be eligible to enroll in an individual plan through a private insurance company or through the Federal Marketplace. While you are a student, it is recommended that your plan provide coverage for emergency and non-emergency hospital services, urgent and sick visits, annual preventive exams, vaccines, mental health or behavioral services, diagnostic testing, and follow-up care for an injury including physical therapy. All of the plans through the Federal Marketplace are Affordable Care Act Compliant and have provisions for the mandated Essential Health Benefits and no restrictions for pre-existing conditions.

Marital and Family Status

If you are married

  • You may be eligible to enroll yourself and your dependents in a family plan through a private insurance company or through the Federal Marketplace.
  • You may be eligible to enroll in an individual plan if your spouse has separate coverage.
  • If you are married and are under the age of 26, you may qualify to be enrolled in your parent (’s) group employer plan.

If you are single

You may be eligible to enroll in an individual plan through a private insurance company or through the Federal Marketplace.

Health Status

Regardless of your current health status, Wheaton College maintains Coverage Guidelines for students to assist you. Recommended coverage includes emergency and non-emergency hospital services, urgent and sick visits, annual preventive exams, vaccines, mental health or behavioral services, diagnostic testing, and follow-up care for an injury including physical therapy.

Good General Health

If you are in good general health without pre-existing or ongoing medical conditions you may consider enrolling in a plan with a higher deductible. The deductible is the amount that you owe for health care services before your health insurance begins to pay. This type of plan typically provides a lower monthly premium but more out of pocket expenses up front when a medical need arises.

Ongoing Medical Needs

If you have ongoing health needs that require frequent medical visits or diagnostic testing, you may consider enrolling in a plan with a lower deductible. This type of plan requires a higher monthly premium up front but lower out of pocket expenses when a medical need arises.

Medication Needs

If you require ongoing medication, you may need a plan that provides this benefit to maintain your health. It is important to identify what coverage a plan provides for prescription medication. Prescription medication benefits are required as an Essential Health Benefits requirement and will be part of a plan that is compliant with the Affordable Care Act.

Financial Status

Finances are at the core of your selection process for a suitable health insurance plan. When you choose between plans you are essentially calculating the amount of financial risk that is acceptable to you in the event that an unexpected illness or injury should occur. Even though there are a variety of plans to view and select from, each plan is derived from the premise that medical expenses can be paid one of two ways. Expenses can be collected up front through higher monthly premiums resulting in lower costs for medical services/products or be embedded in a higher deductible amount, which means that all covered medical services/products are paid out of pocket until the predetermined deductible amount has been met. After the deductible amount has been met, the out of pocket costs for medical services/products will be reduced. Calculating the financial resources that are available and educating yourself about how the plan options are structured will likely increase your comfort level when deciding which plan is best for you.

Federal Tax Requirement

It may be necessary to consult with a licensed insurance agent and/or a tax advisor to learn how the Affordable Care Act (ACA) impacts your Federal income tax requirements. Several informative publications by the Internal Revenue Service (IRS) are available online.  IRS Publication 5187 Health Care Law: What’s New for Individuals & Families offers an overview of the ACA along with a list of publications related to taxes and health care coverage. According to the publication “All U.S. citizens are subject to the individual shared responsibility provision, as are all non-U.S. citizens who are in the U.S. long enough during a calendar year to qualify as resident aliens for federal income tax purposes. Foreign nationals who live in the U.S. for a short enough period that they do not become resident aliens for tax purposes are exempt from the individual shared responsibility provision even though they may have to file a U.S. income tax return.”

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