Forms

The Fall 2022 Medical Enrollment/Waiver Period: Closed at 5PM on September 30th!

All students who were billed the UIUC Student Insurance (medical) fee for the Fall 2022 semester who did not enroll or opt-out during the Fall 2022 Enrollment/Waiver period will be auto enrolled in the UnitedHealthcare medical plan in the upcoming days.

Voluntary Dental and Vision Insurance is now offered separately and available to purchase until October 4th!

 

Early Arrival Coverage - Fall 2022

THE FALL 30-DAY EARLY ARRIVAL PURCHASE OPTION - CLOSED!

THE FALL 14-DAY PRE-ARRIVAL PURCHASE OPTION - CLOSED!

Enrollment Form

The Fall 2022 Enrollment Form/Opt In: Closed at 5PM on September 30th!

The next Enrollment/Waiver Period will be January 13, 2023 - February 24, 2023 for the Spring 2023 semester!

Opting Out of Coverage

The Fall 2022 Waiver/Opt Out Form: Closed at 5PM on September 30th!

The next Enrollment/Waiver Period will be January 13, 2023 - February 24, 2023 for the spring 2023 semester!

In order for a Waiver to be approved, students must provide proof of being actively enrolled in a comparable plan.  

Comparable Requirements: 

Must be a US-based plan with a US phone number. Coverage must be effective on or before the 1st day of the Semester and extend through the remainder of the Academic Year.  Must provide access to in-Network emergent AND non-emergent care within a 50 mile radius of the UIUC campus.  Must be compliant with the Affordable Care Act (ACA).
  • Including but not limited to: 
    • unlimited lifetime benefits
    • no restrictions on preexisting conditions
    • provides benefits for mental health care services

Note:  Approved waivers apply only to the Academic Year during which they were approved.  If you were approved for a waiver during the 2021 - 2022 Academic Year and wish to remain opted-out of UIUC's plan, you must repeat the Opt-Out process for the 2022 - 2023 Academic Year.

If your waiver request was denied, and you believe this decision was reached in error, you must contact United Healthcare Student Resources. 

If your Waiver has been approved, allow 7-10 business days for the fee to credited to your student account. 

Adding a Dependent

If you wish to add a dependent outside of our enrollment period each semester, please email the required documents to our office at insure@illinois.edu listing your UIN.

Please note you may only add a dependent outside the enrollment period if you have a Special Enrollment Reason: newborn, newlywed, or a dependent has a loss of insurance, but you must due this within 30 days of the event.

You must first confirm your enrollment with UnitedHealthcare by filling out the enrollment form /links-and-forms. Once that has been completed you will be able to follow the instructions for dependent verifications.

At least one of the documents listed below must be provided for each dependent, in English, prior to their enrollment being completed.

Acceptable Documents to add dependents:

Marriage Certificate, Birth Certificate, 1040 Tax Return (1st and last pages w/signatures), J1 or F1 Visa (needs to include dependents name), Civil Union Certificate, Military Discharge Papers, MD Attestation for disabled dependents over the age of 26), Guardianship Court Order or Letter signed by a judge, awarding legal guardianship.

Domestic Partnership- at least 3 of the below documents must be submitted:

Joint Mortgage or Lease, Life Insurance Beneficiary Designation, Primary Beneficiary (Will) Designation, Domestic Partnership Agreement, Power of Attorney of Property and/or Health Care, Joint Ownership of either a motor vehicle, checking account or credit card.

Extending Coverage

The Fall 2022 Extension: Closed September 30th! 

Continuation of Coverage

This Fall 2022 Continuation of Coverage form has now closed!
 
Reinstating Coverage

If you opted out of UIUC Student Health Insurance during the 2021 - 2022 school year all previous waivers are null and void. So, if you are registered for qualified classes in Fall 2022 you will be auto enrolled, unless you opt out.

If you have had a loss of other insurance outside our Enrollment/Waiver period and you are registered for on campus classes, please contact our office for assistance.

ID Cards

UnitedHealthcare Student Resources (UHCSR) will NOT automatically send you an insurance ID Card.  You must create a My Account through UHCSR, and from there you will be able to print your ID Card. Go to https://www.uhcsr.com/school-year click on log in to either log in or create an account.

Voluntary Dental Enrollment

The voluntary dental enrollment form closed on October 4 at 11:59pm!

2022 - 2023 Voluntary Dental Plan Enrollment

Voluntary Vision Enrollment

The voluntary vision enrollment form closed on October 4 at 11:59pm!

2022-2023 Voluntary Vision Plan Enrollment