Students with comparable health insurance may apply to opt out of their school’s plan by following instructions from their institution. To do this, follow all relevant steps provided.
Students typically must provide an image and summary of benefits for their health insurance card to prove coverage, with some schools also mandating specific waiver deadlines or risk incurring late fees.
What is a Waiver?
Waivers are signed documents signed by individuals that indicate they agree to waive an existing legal right or obligation, for instance not paying someone else’s medical bills. When it comes time for court challenges against such documents, their wording must always include details about who it applies to as well as specifics about why an individual waives certain rights or obligations.
To be eligible to waive their student health insurance, an individual must meet certain criteria. These standards aim to ensure that individuals opting out have coverage comparable to what SUNY Downstate provides; one such criteria includes having comprehensive health coverage as required by the Affordable Care Act.
Another criterion for enrollment insurance coverage is to maintain it for the entire academic year; otherwise, your insurer won’t permit you to opt-out of enrollment during just one semester versus remaining enrolled throughout. You must submit the waiver by its due date for it to be cancelled and charged off your student account.
Waiver applications must be submitted online through the patient portal. To complete an application for a waiver, log into the portal and click “Student Health Insurance Waiver,” providing subscriber and insurance information as well as an image of your insurance card (optional). It’s essential that sufficient details about alternative coverage options be included to allow independent verification that it meets University criteria for waiver eligibility.
Once your waiver has been approved, an email will be sent directly to the email address associated with your student account and any costs for student health insurance will be removed from your fall tuition bill. Should you change your mind during summer semester enrollment period by logging into student account and selecting “Re-Enroll”, and paying new rates applicable during that term.
How do I get a Waiver?
To waive your student health insurance, complete and submit a waiver form online through the Pace Portal. Your waiver should include information such as your student ID number and social security number so that health insurers can verify coverage.
Midyear is not an appropriate time for canceling insurance plans as the fall and spring semesters are considered one complete policy period. If you wish to opt-out of one plan you are currently enrolled in and waive it altogether, wait for your enrollment cycle’s next add/drop period and wait to do it then.
Aetna provides the university-sponsored health insurance plan with comprehensive, Affordable Care Act-compliant coverage, making this plan available to most of our international students and many domestic ones alike. If your existing plan meets or exceeds our requirements, students may opt out. However, most students must comply with university rules regarding student health coverage including international students.
All full time undergraduate and graduate domestic and international students enrolled in full time studies are automatically enrolled in Aetna’s school accident/sickness plan; those who already have alternative coverage can opt-out by providing evidence of coverage as well as filling out a waiver form in the Patient Portal.
Students opting out of SUNY Downstate health insurance must secure comparable or superior coverage and costs with other policies, which includes medical, dental and behavioral coverage. Opting out does not exempt from paying fees associated with Pace student health clinic services but you will remain accountable for any physician or hospital bills incurred while at university.
International students studying in the United States must have enough funds to support themselves during their stay here, if applicable. Accepting public assistance such as Medicaid could deem you as “public charges”, hindering future visa applications or renewal processes.
Students should carefully read and complete their waiver forms; incomplete submissions will be denied.
What if my Waiver is Denied?
Students should familiarize themselves with their institution’s waiver process and deadlines, which should generally be posted on its home page. Graduate assistants (GAs) can find more information regarding their health insurance plan by visiting the GA Student Health Website; generally speaking, insurance waiver process begins during summer term to cover academic period following that.
Schools typically set deadlines by which students must provide alternative insurance plan details. If no waiver application is submitted by this date, students will automatically enroll in their school’s plan for fall term enrollment; and if no approval for waiver application has been provided by that time either, fees will be added onto subsequent tuition bills.
Whenever a student’s waiver request is denied, the university will send them an email outlining why it was rejected and instructions on how to file an appeal within 10 business days from when their decision was issued.
Most often, waiver denial occurs because student coverage does not meet minimum essential benefits established by their institution. When this happens, school officials often require additional documentation showing that your plan meets these standards.
A student’s insurance plan premiums can often determine whether their school accepts them as waivers; fees charged by schools often outstrip prices in the private marketplace for equivalent coverage.
If the student’s waiver request is approved, a credit will be applied back to their student account within 1-3 business days and listed as “Insurance Waiver.” Students should carefully monitor their eServices account to make sure this credit appears correctly as any discrepancies could lead to a financial hold on their account that prevents registration, transcript processing or the receipt of diplomas.
What if my Waiver is Accepted?
Once your waiver request has been approved, the insurance fee will be removed from your student account within two to three business days. Therefore, it’s essential that you check on your student account regularly to make sure it has been successfully processed.
Waivers will only be approved if your current coverage fulfills University criteria outlined in its waiver eligibility checklist and may vary over time. If your waiver request is denied, then you will remain enrolled in a University plan and charged its associated premium.
Once approved, your waiver request remains in force for the academic year it was filed in. To change or modify it in future years, simply submit a new request.
To expedite review of your waiver quickly, it is recommended that when submitting it you upload a copy of your health insurance card as well as an overview of benefits. Also important is providing the exact name of the insurance company when entering it on the form.
If your policy resembles ours, please fill out an online waiver request form by following the link below and selecting “Student Health Insurance Waiver”.
Please be aware that it is only possible to forgo health insurance coverage if your existing comparable plan meets Albany, NY standards – such as non-University plans as well as NYS Essential Plans for visa holders (please see FAQs section above for further details).
HSA Consulting will require your student ID number and Social Security number in order to verify your insurance coverage, otherwise our partner provider cannot verify your coverage and a waiver could be denied.
If you currently have an active student health insurance policy from another provider that meets our criteria, but does not satisfy University insurance criteria for each academic year, an updated waiver form must be completed each time as these can change over time.