Apply for Waiver
Information and Steps to Apply for Health Insurance Waiver
PLEASE NOTE YOU MUST MEET THESE CRITERIA BEFORE CONTINUING:
- One you have used UnitedHealthcare insurance the coverage cannot be terminated.
- Your insurance provider must be based in the United States
- Your insurance must be an Affordable Care Act compliant plans. Any Medicaid plans based outside of NY and the NY state Essential Plan will not be accepted
The following additional plans will not be accepted:
- AIG General Insurance Company Ltd.
- HTH Worldwide
- International Student Protection (ISP)
- UnitedHealthcare’s PGH/Student Resources Product
- ICIC Lombard
- International Medical Group (IMG)
- Seven Corners
- Global Benefit Group (GBG)
- Tokio Marine HCC
- Fallon Community Health Plan (Massachusetts Medicaid)
- Partners Health Plan (Massachusetts Medicaid)
- Peach State Health Plan (Georgia Medicaid)
- Affinity Health
- Emblem Health with ID numbers of LLNNNNNL or Emblem Health (HIP MA)
- Medi-Cal (California Medicaid)
- Populytics- LeHigh Valley Health Systems
- Healthy Connections – South Carolina Medicaid
- Gesinger Insurance Plans
- Health New England
- Care1st (Arizona- Medicaid)
- Boston Medical Center Healthnet Plan (Medicaid)
- Neighborhood Health Plan of Rhode Island (Medicaid)
- Gateway Health Plan (PA- Medicaid)
- Wellcare of NY
- MassHealth (Massachusetts Medicaid)
- Molina (Medicaid Based Plan)
- Husky (Connecticut Medicaid)
- United Healthcare Community Plan (New Jersey)
- Christian Healthcare Ministries
- Liberty Health
- Global Benefit Group
- Tufts (Rhode Island & Massachusetts Medicaid only)
- YourCare Health Plan
- Emblem Health (only HIP MA) or id# that starts with JNR
- Any Medicaid or Medicare Plans that are not based in Central NY and Medicaid plans that start with FU in your ID#
If your policy meets the above minimum requirements, please print out WAIVER APPLICATION INSTRUCTIONS AND FORMS. Please read instructions thoroughly.
NOTE: GAs, TAs, Lecturers and Research Foundation Student employees who are covered under SEHP/NYSHIP/RF Health Insurance do NOT have to apply for the waiver. Even though, you do not have to submit a waiver, please make sure to pay your insurance fees before the due date in order to avoid late payment fees. Your paid insurance fee will be refunded once the waiver is processed.
Waiver Application Deadline:
Fall Semester is October 15.
Spring Semester is February 15.
Waiver application applies to health insurance only. Students CANNOT waive out of the emergency assistance and evacuation insurance.
Please deliver completed forms to our office or scan and email ONLY in PDF format to EMAIL: email@example.com. Smartphone pictures cannot be accepted.