University of Rochester University of Rochester


1. The plan covers a minimum of $500,000 US in medical benefits due to illness, accident or injury per planyear.

2. The plan has a deductible of $5,000 US or less per covered person per plan year.

3. The plan covers prescription medications both in the hospital and out of the hospital to a minimum of $100,000 US per plan year.

4. The plan covers all pre-existing health conditions without restriction.

5. The plan covers biologically-based mental health illnesses at the same level as other medical conditions.

6. The plan covers care related to pregnancy and delivery, including newborn care for the first 30 days of life.

7. The plan covers care for self-inflicted injury, intercollegiate and recreational athletics and activities.

8. The plan will be in force for the duration of the academic year, or at least through the end of the month in which graduation or end of the University of Rochester academic program occurs



University of Rochester Insurance Waiver Appeal Form
Copies of Insurance policies are not acceptable.
The University of Rochester requires all full-time students to maintain health insurance coverage for
medical care, mental health, and catastrophic illness and injury. Students may satisfy the insurance
requirements through public, private or employer sponsored plans that meet certain minimum criteria.
Students with insurance companies from outside the United States must complete this form to appeal
enrollment in the University-sponsored plan. All Fall submissions are due by August 15, 2012 and will be
audited. Late submissions will not be accepted. Those failing audit will be enrolled in the UR-sponsored plan.








insurance waiver form

















$ 1,000,000



































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