Forms
Summer 2023 Medical Enrollment/Waiver Period:
May 12th at 8am CST - June 23rd at 5pm CST!
Summer 2023 Medical Coverage Dates: May 13, 2023 - August 20, 2023
All students billed the UIUC Student Insurance (medical) fee per semester will be auto enrolled once the Enrollment/Waiver period closes, unless they opt out.
If you successfully opted out during the Fall Enrollment Period and wish to remain opted out, you do not need to take any action.
Students will receive (6) weekly emails during the Enrollment/Waiver Period, outlining all of the options and resources available to them. Please pay attention to these emails and contact our office with any questions.
- Early Arrival Coverage
- Enrollment/Opting-In Form
- Waiver/Opting-Out Form
- Adding a Dependent
- Extending Coverage
- Continuation of Coverage
- Reinstating Coverage
- ID Cards
Early Arrival Coverage - Summer 2023
- This will not be offered for Summer 2023!
- View the step-by-step instructions document for assistance with purchasing early arrival/pre-arrival coverage.
Enrollment/Opting-In Form
- The Summer 2023 Enrollment Form will be available May 12th at 8 am CST - June 23rd at 5pm CST!
- The Enrollment Form must be filled out during the Enrollment/Waiver period, prior to adding dependents or printing off your ID Card.
- If you need to receive medical services prior to the end of the Enrollment Period, please complete and submit this form. Otherwise, you will be auto-enrolled with 3 business days following the end of the Enrollment Period.
Waiver/Opting Out Form
- The Summer 2023 Waiver will be available May 12th at 8 am CST - June 23rd at 5pm CST!
- 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 radium 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
- Including but not limited to:
- Note: Approved waivers apply only to the Academic Year during which they were approved. If you were approved for a waiver for Fall 2022 there is no action required.
- 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
-
Please do not upload documents more than once. If you had your dependent on the Student Insurance plan the previous semester, opt in then allow up to 72 hours for a payment link to be sent to you.
- You may only add a dependent once you have opted in each semester. The Summer 2023 Enrollment will be available May 12th at 8 am CST - June 23rd at 5pm CST!
- 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 Summer 2023 Extension will be available May 1st at 8 am CST - June 23rd at 5pm CST!
- If you are not enrolled for classes for an individual Semester and wish to extend your coverage, you can purchase an Extension. However, you must have been covered during the previous semester and plan on returning the following semester as a on campus student.
Continuation of Coverage
- The Spring 2023 Continuation of Coverage form will be available 30 days prior to your coverage ending an up to 30 days after your cover ends!
- If you did not have a dependent on the plan when you graduated, you will not be able to add coverage for your dependent.
- If you were enrolled in the Student Health Insurance plan, and wish to continue coverage after graduation, you can purchase coverage for up to 90 days (30-day increments). Please login to your My Account through the UHCSR website. https://www.uhcsr.com/illinois.
Reinstating Coverage
- If you opted out of UIUC Student Health Insurance during the Fall 2022 semester and would like to get back on the Student Insurance plan for Summer 2023. You must be registered for Summer 2023 classes and complete the reinstatement form.
- The Reinstatement form will be available May 12th at 8 am CST - June 23rd at 5pm CST!
- 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.