Insurance Requirements Details
Insurance Requirements Details
All full-time registered students must have health insurance that ...
- is provided by a company licensed to do business in the United States, with a U.S. claims payment office and a U.S. phone number.
(RATIONALE: Health plans licensed outside of the U.S. or without a U.S. claims payment office/U.S. phone number rarely meet U.S. standards for insurance, and usually have restrictions that create barriers to students accessing care.)
- has unlimited annual and lifetime benefits (i.e., no policy maximum).
(RATIONALE: This is an Affordable Care Act standard.)
- will be in force for the duration of the academic year, or until their program ends.
(RATIONALE: Students cannot have gaps in coverage.)
- *NEW*: provides “Federal bronze level” 40% coinsurance (meaning the plan pays 60%) or better coverage for health care where the student is attending school (Ithaca** or elsewhere).
Coverage must include:
– Inpatient Care
– Emergency Care
– Urgent Care
– Specialty Care
– Diagnostic Imaging and Testing
– Outpatient Mental Health Care
(RATIONALE: Bronze is the minimum ACA-compliant coverage level.)
**Ithaca-based students are encouraged to have in-network coverage at Cayuga Medical Center (CMC), which is the only provider of hospital-based services accessible by public transportation in Tompkins County (see insurance plans that CMC participates with). Cornell is working to improve options for accessible in-network care for students on the Ithaca campus; learn more below.
- *NEW*: is NOT…
... a Health Maintenance Organization (HMO) plan without an “away from home” rider.
(RATIONALE: HMOs effectively provide ‘emergency only’ coverage for students when they are away from home, unless the student requests an away from home rider. Not all HMOs offer such riders, and some charge additional premiums for riders.)
... an out-of-state Medicaid plan.
(RATIONALE: Out of state Medicaid provides ‘emergency only’ coverage when the student is away from home.)
... a catastrophic ("young invincible") plan.
(RATIONALE: These plans provide limited coverage for the services outlined in Requirement 4.)
The requirements for waiving the Student Health Plan became part of a community dialogue this year when we began to more carefully audit compliance. That audit found that many students were waiving with insurance that did not meet a key requirement – coverage for health care where the student is attending school (Ithaca or elsewhere) at a reimbursement rate of at least 70%. In particular, United Health Care insurance plans frequently failed to meet that requirement for students in Ithaca, where the only hospital reachable by public transportation is not a UHC provider.
This fall, senior university leaders reviewed available data, feedback from students and parents, and recommendations from the Student Health Benefits Advisory Committee, Cornell Health, and the Office of Risk Management and Insurance. Based on that review, we approved the new requirements for the 2019-2020 academic year. We believe these changes, in line with federal minimum standards, will improve the waiver experience for students who wish to maintain their own insurance.
Accessible in-network options for the Ithaca campus
Cornell representatives are currently working with Cayuga Medical Center (CMC) leadership to encourage CMC to become an in-network provider for United Health Care (UHC), one of the largest insurance companies in the country (more than 20% of Cornell students who waive SHP are covered by a UHC product). CMC has offered to partner with Cornell to find creative solutions to make services more accessible and affordable for Ithaca students with UHC products. University administrators and the Student Health Benefits Advisory Committee will review options proposed by CMC, along with other options, to determine next steps in the process.
Updates to this ongoing process will be published on this page. Please check back for more information.