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Health Insurance Policy Rationale

Rationale for Cornell Health Insurance Requirements 

In 1974 Cornell's Board of Trustees instituted a university policy requiring all students to have quality health insurance. This ensures that lack of access to healthcare is not a barrier to the success of any student.

Cornell's criteria for quality health insurance are designed to ensure that all students have access to professional, timely, confidential, and affordable medical and mental health care, and are protected against unforeseen costs that could undermine their education or financial or personal well-being.

Below is a brief overview of the rationale behind the specific requirements of coverage for all students. For the coverage requirements for students seeking to waive or terminate coverage in Cornell's Student Health Plan, please see the Waive or Cancel SHP section of our website.

  1. 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.

  2. Unlimited annual and lifetime benefits is Affordable Care Act standard

  3. Students cannot have gaps in coverage, so we require that the policy is in place year-round. We additionally reverify waivers in January when U.S. employer plans and health exchanges typically renew.

  4. Bronze level coverage means the health insurance plan pays 60% of the cost of care and the insured pays 40%. Bronze is the minimum ACA-compliant coverage level.

  5. 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. Emergency only coverage does not allow for prescriptions or care outside of the emergency room. If the insurance company rules that the event was not an emergency, then the student could be responsible for the full cost of care received.

  6. Out of state Medicaid provides ‘emergency only’ coverage when the student is away from home. Emergency only coverage does not allow for prescriptions or care outside of the emergency room. If the insurance company rules that the event was not an emergency, then the student could be responsible for the full cost of care received.

  7. Catastrophic plans provide limited coverage for the services outlined in Requirement 4.

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).