QUESTION

I’m enrolled in student health coverage now, but I think I can get a better deal in the marketplace. Can I drop student health plan coverage and go to the marketplace instead?

Individuals with coverage | Issues For Young Adults: Student Health Plans and Coverage on Parent’s Health Plans
ANSWER

If you are currently enrolled in a student health plan, you can still qualify for marketplace policies and subsidies if you apply during open enrollment. During open enrollment, you can sign up for a marketplace plan and, if your income is between 100 percent and 400 percent of the federal poverty level you can also apply for premium tax credits. You will have to drop your student health coverage before your marketplace plan becomes effective in order to be eligible for premium tax credits.

Outside of open enrollment, you cannot voluntarily drop your student health plan coverage in order to qualify for coverage and premium tax credits. However, if you involuntarily lose eligibility for student health plan coverage mid-year – for example, if you drop out of school and so lose eligibility for the student health plan – you will qualify for a special enrollment opportunity and be able to apply for marketplace coverage and premium tax credits. The special enrollment opportunity will last 60 days, so be sure to contact the marketplace promptly to notify them of your qualifying event. (45 C.F.R. §§ 155.410, 155.420).

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