Domestic Student Health Insurance Waiver

Request a waiver for the premium refund if your policy matches or exceeds the UB-sponsored policy.

If you did not yet read the informational insurance information, please do that before completing and submitting this form.

Request a Waiver

Spring Waiver is for New Students Only.

If you completed the waiver for Fall 2019, you do not need to fill out the waiver for the Spring 2020 semester. 

Accessibility

* The University at Buffalo is committed to ensuring equal access to information that is presented online. As part of this commitment, university web content must be accessible to everyone, including individuals with physical, sensory, or cognitive impairments, with or without the use of assistive technology. If you encounter an accessibility issue when completing this form, please contact the health insurance office.

For the best experience use a non-mobile device.

Check Your UB Email

It is your responsibility to check your UB email. If you request a waiver and it is denied, your notification will arrive via email. In addition, the University no longer generates a paper tuition statement. Your Student Account Statement is by eBill only. Failure to view your eBill details will not be accepted as a reason to waive the insurance charge after the published deadline.

To Get Help

For domestic students; only for waiver requests or to terminate your coverage.

500 Victory Road
Quincy, MA 02171

Phone: (877) 231-9757; Fax: (617) 479-0860