July/August 2008

Summer is an exciting time for many PAMF patient families as they prepare to send their young adults off to college, internships or new jobs in other areas of the country. To help ensure these young people will continue to receive quality health care after they have left the nest, PAMF encourages parents to review insurance options now.

Below are several common questions about health insurance for young adults.

Can a young adult continue to stay on his or her parents' insurance?

Most insurance plans allow young adults to stay on their parents’ insurance until a certain age, especially if they are students.

How is emergency medical care that is received away from home handled?

Most insurance plans will cover care received for true emergencies at the facility closest to where the patient is located. Patients should check with their health plan regarding how to handle bills from such visits.

How is non-emergency medical care away from home handled?

That depends on the type of insurance the young adult has. When PAMF is the young adult's primary medical group, most Health Maintenance Organization (HMO)/Point of Service (POS) plans require the member to see a PAMF doctor for non-emergency care. Point of Service (POS) plans may cover non-emergency care obtained outside of PAMF's network, but the co-pay is typically higher. Note: Follow-up care received after initial emergency care, such as check-ups after emergency room visits or physician therapy after emergency treatment for an injury, is typically not covered when obtained out of network.

Finally, Preferred Provider Organization (PPO) plans may allow young adults to pick a doctor or medical group near where they live, provided that doctor or medical group is in the plan's network. Each plan differs, so it is best to check with the insurer directly regarding what medical services will be covered away from home.

Should young adults get their own insurance?

Again, it depends on the insurance plan. Most colleges and universities offer limited medical insurance plans, either as part of their basic fees or as a supplement that parents may buy separately. Young working adults without employer-provided health insurance can buy individual insurance. Both school-based and individual insurance plans vary in what they cover. Some cover costs for catastrophic illness or accident but not routine medical care.

Therefore, it is best to review both college or university and private plans carefully before signing up. They may cover only limited services.