College students experience healthcare insecurities, with underinsurance and limited care options highly prevalent. The current study measured the prevalence of delaying care, the relationship between delaying care and mental health outcomes, and the role of using university health services (UHSs) in a sample of n = 498 college students. Participants reported whether they delayed healthcare due to cost or insurance and their use of UHSs. Mental health outcomes included screening positive for depression, anxiety, and suicide ideation. Overall, 36.9% of participants delayed healthcare in the past 12 months, and 38.8% reported using UHSs. Delaying care was associated with higher odds of screening positive for depression (ORadjusted[95%CI] = 2.79 [1.81,4.31]), anxiety (ORadjusted [95%CI] = 2.58 [1.68,3.98]), and suicide ideation (ORadjusted [95%CI] = 4.14 [2.12,8.11]), although there was no significant relationship with using UHSs. Universities should consider improving logistics, access, and service quality of UHSs or improved access to off-campus services.