What You Need to Know
To waive UC SHIP coverage, you must have other health insurance coverage that meets the university’s health insurance requirements, described in the waiver criteria below. You must submit a waiver application prior to the start of each new academic year to waive coverage that year.
Waiver Criteria for 2023/2024 Academic Year
All plans must provide unrestricted access to an in-network primary care provider and in-network hospital and to full non-emergency medical and behavioral health care within reasonable distance of campus or the student’s place of residence (if online learning only) while attending school. Such distance shall be determined at the discretion of each campus based upon its unique geographic considerations and local availability of services. (The waiver form will indicate the distance requirement appropriate for each campus.)
NOTE: This criterion applies to all plan types without exception, including Medi-Cal or Medicaid, Medicare, TRICARE/military, Veterans Affairs benefits, HMOs (including Kaiser, WHA and others), Covered California or other U.S. federal or state exchange plans, and all employee-sponsored and individual plans.
Coverage must be currently active, and the student must agree to maintain health coverage throughout the entire academic year. If your current insurance coverage is terminated, contact the Student Insurance Office as quickly as possible to discuss your health insurance options.
To satisfy UC’s health insurance requirement for enrolled students, the insurance plan held by the student must provide the following:
- Be a Medi-Cal/Medicaid, Medicare, TRICARE/military, Veterans Affairs benefits, Covered California or other U.S. federal or state exchange plan, or a UC employee health plan, OR
- Be an employer-sponsored group health plan or individual plan that:
- Has an annual out-of-pocket maximum of $8,700 or less for an individual or $17,400 or less for a family. Deductibles, copayments and coinsurance paid by the member accrue toward meeting the out-of-pocket maximum. A higher out-of-pocket maximum is allowed if the member has a Health Savings Account (HSA) or a Health Reimbursement Account (HRA).
- Covers inpatient (hospital) and outpatient care for mental health and substance abuse disorder conditions the same as any other medical condition.
- Covers doctor office visits for medical, including mental health, and alcohol/drug abuse conditions.
- Provides coverage for all minimum essential health benefits (EHB). For the criteria, please go to the Centers for Medicare & Medicaid Services (CMS) website.
- Is not a health care or pharmacy reimbursement plan (reimbursement plan means the student must pay for services and seek reimbursement from the insurance provider).
- Does not have a per-medical or per-mental health/substance use disorder condition maximum dollar limit.
For international students residing in the U.S., the following additional criteria apply. The plan must:
- Have no per-medical or per-mental health/substance use disorder condition maximum benefit limits.
- Cover services related to suicidal conditions, including attempted suicide or suicidal thoughts.
- Cover medical services for injury from participation in all types of recreational activities or amateur sports.
- Have no preexisting condition exclusion or limitation; if the plan has a preexisting condition waiting period, that period must have expired.
- Have no lifetime maximums on benefits.
- Have a complete master policy written in standard English with benefits expressed in U.S. dollars.
- Have a claims payment office with an address and phone number in the United States.
- Pay at least $50,000 annually for medical evacuation.
- Pay at least $25,000 for repatriation of remains.
The Waiver Process
Academic HealthPlans manages the waiver process through its website. It’s where you’ll initiate your request, submit all required documentation, and make any updates to your existing application.
Want to Waive UC SHIP Coverage?
Academic HealthPlans’ (AHP’s) website makes it fast and easy to submit documents and complete the UC SHIP waiver process online.
Applying for a Waiver
Here are seven things to know when you apply for a waiver.
- You must submit the waiver application and supporting documents during the waiver period.
- You must submit the waiver application for each academic year you want to waive UC SHIP coverage.
- You can complete the application online during the fall, winter or spring waiver periods. Your waiver will be applied to the full academic year — or to the remainder of the academic year if you apply during the winter or spring terms.
- When you submit a waiver application, we contact your health insurance company to verify that you are actively enrolled. You will receive a quick response to your application.
- If your waiver is approved, you must maintain active enrollment in your health insurance plan for the entire academic year. Before the start of every term, we reverify that you are enrolled in your health insurance plan.
- If we cannot verify that you are actively enrolled in a health insurance plan, you will be notified by email and/or text message that your waiver was denied. You will then be enrolled in UC SHIP and charged the cost of coverage for that term.
- If your waiver is denied, you can appeal the decision by submitting proof of current insurance coverage from your health insurance plan.