What percentage of college students are estimated to have no health insurance?

As college students buckle down to research papers and problem sets, another subject--health-insurance plans--deserves study as well.

Full-time college students frequently are covered under a parent's policy or university-offered plan. As a result, just 20 percent of full-time students ages 19 to 23 go uninsured, while 40 percent of non-students and part-time students lack coverage, according to a study this year by the Commonwealth Fund.

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Even so, experts say that students' insurance often is inadequate, for several reasons:

- Services are not within network.

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Your parent's health insurance plan may be restricted to an area that's close to home--a problem if you move cross-country to go to school. Most student health centers allow you to meet with a physician for free, but if you need additional services, such as lab tests or an X-ray, you could have to pay out of pocket.

- You're not a "dependent student."

To qualify for coverage through a parent's policy you often have to be a full-time student, not part-time. Even then, most plans kick you off when you hit 23, or when you cannot be claimed as a dependent on your parents' tax return.

"And we're finding that more employers and insurance companies are doing audits," said Stephen Beckley, a health-care management consultant. "We're running into students who say, `I just found out I don't have health insurance.'"

- You're on the hook for catastrophic costs.

Because college health plans originally were designed to supplement a student's medical insurance, not replace it, many policies offer skimpy protection.

So, for example, instead of offering up to $500,000 in catastrophic coverage, the recommended minimum, university plans might cap it significantly lower.

"The ground changed beneath colleges' feet," Beckley said. "And to design full-service plans for the student population requires extraordinary resources that most student affairs [offices] just haven't come to grips with."

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In fact, less than 2 percent of schools complied with standards on student care endorsed by the American College Health Association in 2000. Beckley estimates that has risen to about 10 percent today.

The uptick is a positive sign, Beckley said. At the same time, some state legislatures have passed laws making it easier for twentysomethings to continue under their parents' coverage.

What should you do?

- Review your coverage.

Pull out whatever policy you have and take a close look. Could you afford the deductible if you needed care? Can you access medical services in your area, besides just the emergency room? Is your catastrophic coverage sufficient?

Oftentimes your parent's insurance will be the most comprehensive plan, as long as you can access doctors where you go to school. But if your area is not covered, and you live several hours from home, you may want to check into your school's policy.

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Even if your school's health plan has been lacking, it may be worth another look.

Emory University in Atlanta, for instance, revamped its student medical insurance plan four years ago to mirror the level of coverage available to faculty and staff.

"The plan used to have caps on a lot of stuff that you really need to be appropriately insured," said Dr. Michael Huey, executive director of Emory's student health and counseling services. "So we did a major revision because we want our students to be able to complete their academic work and go off and make a difference, not get sidelined by medical bills."

In some states, such as Massachusetts, where it is mandatory for students to have coverage, college health plans tend to be better, said Sara Collins, an assistant vice president for the program on the future of health insurance at the Commonwealth Fund.

"There's a larger insurance pool," Collins said.

- Seek other options.

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It may be that neither your parent's policy nor a student health plan offers coverage.

If so, consider extending your parent's insurance through Cobra, in which you pay up to 102 percent of the full premium of an employer-offered plan. Though not cheap, Cobra is often more affordable than what you would pay for the same coverage as an individual, Collins said. Plus, there are no exclusions for pre-existing conditions.

But act fast: You have only 60 days to sign up for Cobra benefits once you initially lose coverage.

Also, check out low-cost individual health insurance sold online (www.ehealthinsurance.com and www.goldenrule.com). Plans are not available in all states and pre-existing conditions often are excluded during the first six to 12 months of coverage. But you can find low deductibles and 20 percent co-pays for doctor visits.

It's not perfect, but it's certainly better than risking thousands of dollars in medical bills because you had no insurance at all.

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