Two Approaches to International Student Health Insurance; and why one is better

Jeff Foot | 1-17-2018

The cold winter blast is an eye-opener for Harish. The sophomore student from South Asia is much more accustomed to waking up to the sound of waves hitting a beach instead of the howl of an arctic cold front. Harish bundles up the best he can and sets out for his first morning class at his Midwest college. Harish is excited to be in America, but he has never really experienced this kind of weather before. Unfortunately, unseen ice on the sidewalk sends him tumbling just a few steps from his dorm. The pain in his wrist is intense and he knows immediately he has a very bad injury.

Depending on his school’s international student health insurance, Harish’s accident could be a minor inconvenience or a major financial event that forces him to return back to South Asia within days. Colleges (and some internationally focused high schools) take two distinct approaches to insuring international students.

Some schools take a “laissez-faire” approach and let international students search and buy their plans individually. If this were the case for Harish, at orientation he would be given the name of a couple of insurance companies or brokers to contact. It’s hard for U.S. citizens to understand our own health system, much less force an international student with English as an additional language to shop an insurance policy for him or herself. In my experience, Harish would delay buying insurance, or if he did in a timely manner, would buy an insurance policy with a high deductible and more coverage than he needed.

Most schools, however, require their international students to have health insurance (mandate coverage) through a group plan supported by the school. Institutions who mandate coverage usually follow one of two approaches; they group all domestic and international students together or separate them into two unique insurable groups.

For Harish, being covered on an ACA-compliant plan would mean paying a high out-of-pocket cost (likely at least several thousands of dollars) to fix his wrist.

Often the best financial and coverage option for international students are at institutions who mandate coverage AND separate international students from domestic students. By separating the two demographics, international students will have the benefit of coverage tailored for them with little to no deductibles and/or copays. This approach allows the international office to be an active participant in selecting the insurance product since there can be specific benefits attached.

International student health plans under this model are usually limited to a policy year maximum (which equates to the student’s enrollment period) or have pre-existing condition limitations (i.e. pregnancy occurring before coming to the United States.) If Harish’s Midwest college had selected such a plan, he would pay a $20 copay for the office visit and that would be it. Harish’s family has already sacrificed so much for him to have the opportunity to study in the U.S.; a custom international insurance plan will help protect their investment.

As the regulations around the Affordable Care Act change, international student coverage will continue to be impacted by:

  • How institutions choose to think about serving international students who are cost sensitive,
  • Having differentiated services that put the best interests of international students first,
  • And, how welcome international students feel while studying in the U.S.

I assert international students need differentiated services and reap the benefits of who they are—in terms of health insurance coverage—which means lower rates because globally mobile students are younger and healthier than almost any other demographic.

At LewerMark, our focus is purely on the best coverage levels for international students and serving them with innovative and meaningful support.

Contact me at 1(800) 821-7715 x112, or at if you would like to discuss how you think about this topic and if our model fits with your needs.




Author: Jeff Foot

Jeff Foot is the Executive Director at LewerMark and is responsible for developing new client relationships. He joined LewerMark after spending 17 years at Northwest Missouri State University where he served as Director of Admissions and International Affairs. While at the university he also served as International Affairs Director and Data Specialist for the Intercultural International Center. He has a doctoral degree in Educational Leadership and Administration from the University of Missouri, a Master of Science degree in Educational Leadership and Administration from NMSU and a Bachelor of Arts Sociology from the University of New Brunswick in Canada. Foot also led the English as a Second Language Program at Byuk Sung College in South Korea from 1998 to 2000.