What You Need to Know About Health Insurance for College Athletes

by
Content Marketer, ValuePenguin

College sports allow many young athletes the chance to get a low-cost education and maybe even play for a professional league eventually. According to the NCAA, more than half of all Division I and II athletes receive some form of athletics-based financial aid. That aid typically goes toward paying for the essentials such as tuition and fees, but it doesn’t cover medical insurance in most cases.

Health insurance is essential for student-athletes, who are far more prone to different kinds of injuries. The average university-level athlete experiences about two injuries per year while playing team sports. In particular, contact sports such as football result in the most severe injuries that require longer recovery times and higher costs.

The NCAA requires all college athletes to carry health insurance in order to participate in any NCAA sport at any Division level. Incoming athletes and their families should explore all available insurance options and weigh the injury risks based on the type of sport the student plays.

Related: Health Insurance in College: What Options Are Out There?

NCAA medical insurance rules

The NCAA insurance rules can be complex to navigate, and accurate information isn’t always easy to find. However, every athlete should ensure three basic criteria are met before entering college to play sports:

  • The student has a medical insurance policy that is equal to or greater than the deductible offered by the NCAA Catastrophic Injury Insurance Program
  • The student’s university or college has provided a certificate stating the insurance policy is in place and active
  • The health insurance policy will be active through all years the student is participating in college-level NCAA sports

At a basic level, the NCAA requires all college-level student-athletes to carry health insurance. That policy can be through a parent’s insurance, a private student plan, or through the university.

Prior to 2005, many students and their parents had to pay out of pocket for expenses due to the cost and nature of some sports injuries. However, the NCAA passed legislation in 2005 that requires all universities to certify students have adequate coverage before they participate in college-level sports.

The NCAA also established a Catastrophic Injury Insurance Program, paid for by the NCAA, which offers coverage for students and their families whose injuries exceed $90,000 through private insurance or $75,000 through institutions participating in the NCAA Group Basic Accident Medical Program.

Some have suggested the NCAA still needs to provide a more centralized option for health insurance coverage for student-athletes. There’s currently no option for this, so students and their parents should explore employer-provided health insurance, private health insurance, or the university or college’s insurance options.

Employer-provided health insurance

The Affordable Care Act (ACA) changed the law to ensure young adults could stay on their parents’ health insurance until they’re 26 years old. For many student-athletes and their parents, this may be the easiest way to meet the NCAA’s minimum health insurance requirements.

Parents or guardians who currently have insurance offered through an employer may need to reassess the coverage limits. Per NCAA rules, students must have insurance with coverage that at least matches the coverage provided by the Catastrophic Injury Insurance Program deductible ($90,000). Keep in mind that an increase in coverage can result in higher premiums. 

Private and marketplace health insurance options

Both student-athletes or their parents or guardians can still obtain health insurance to meet the NCAA’s medical insurance requirements if it’s not offered through an employer. They should explore their options across the marketplace exchange or seek private policies. As with employer-provided health insurance, parents who are insured privately can keep a child on their family insurance policy until the age of 26.

Rates depend on age, geographic location, career, tobacco use (including e-cigarettes), and the number of people insured. Students who obtain insurance privately without a parent or guardian may also receive higher rates due to the higher risk of injury associated with college sports.

University-sponsored health insurance

Most universities and colleges now provide health insurance policies that students can use. These insurance policies may be cheaper than private health insurance plans or those through the HealthCare.gov marketplace, so they may be a good option for student-athletes who can’t or won’t get coverage through a parent’s or guardian’s policy.

University Health Plans has a database for students that helps identify which colleges and universities provide insurance coverage. However, you may need to contact your institution directly to determine if it participates in the NCAA Group Basic Accident Medical Program. Additionally, you’ll need to verify that your university provides enough coverage to meet the Catastrophic Injury Insurance Program deductible limits.

How to choose a health insurance policy for student-athletes

Outside of the NCAA’s minimum requirements, parents and students should strongly consider the additional risks associated with different sports.

Although the NCAA will pick up the tab to keep athletes and their families from paying excessive amounts out of pocket, some injuries will not be covered by the NCAA. Some sports can result in minor injuries that go undetected and later result in worse injuries that may not be covered by the NCAA’s Catastrophic Injury policy.

Additionally, some sports cause injuries that are either more serious or more frequent such as:

  • Football
  • Basketball
  • Soccer
  • Gymnastics
  • Baseball

Some college sports have fairly low rates of injuries and fewer severe injuries, including:

  • Rifle
  • Water polo
  • Swimming & diving
  • Rowing

The types of injuries common among sports may also be a determining factor. Although sprains and strains make up more than half of all college sports injuries, major injuries such as concussions and fractures are also common. The cost of recovery for different types of injuries is important to consider.

Some sports, especially football, are more likely to result in major injuries that require expensive surgeries. Before choosing or extending a health insurance policy, determine if the sport has a greater risk of expensive injuries. For example, if the most common injuries are sprains or strains, you may need less coverage than sports where bone fractures are common.

Related: The Concussion Effect

Account for out-of-area coverage

Travel is common in collegiate sports, whether it’s national or international. Parents and student-athletes will need to ensure they’re fully covered outside of their normal geographic area.

Some providers offer extended out-of-area coverage, but they may charge higher rates for emergency services. It’s important to discuss and explore how out-of-area coverage works with potential providers. Additionally, student-athletes and their families should consider how frequently the student will travel to determine which policies offer the best coverage.

Account for sports injury recovery times or disabilities

Some injuries may take longer to recover from, and they may incur additional costs from doctor’s visits, medication, equipment, and professional therapy sessions.

Recovery times for sprains or strains could take a week, but major muscle pulls could take months of recovery before a student-athlete can retake the field. Those recovery times can also be costly and require multiple trips to visit health professionals and physical therapists. Broken bones and fractures can also take weeks or months to heal, while ACL sprains or tears could take upward of a year to fully heal.

Note that it’s possible for student-athletes to lose their sports scholarship in the case of severe injuries. Although most colleges and universities will maintain a scholarship during a recovery period, if the period extends too long or the student is unable to return to the sport at all, the scholarship may be rescinded.

With such a risk in mind, students and their families may want to consider the NCAA’s Exceptional Student-Athlete Disability Insurance. This insurance provides compensation for students who are disabled while playing football, men’s or women’s basketball, baseball, or men’s ice hockey. This option is offered specifically for students who may have gone on to professional careers in these sports but whose injuries created a disability prior to graduation or selection into the professional league.

For more advice on what you need to know as a college student-athlete, check out our College Athletics section.

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