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Mailing Address
Cleveland State University
Center for International Services and Programs
2121 Euclid Avenue
Cleveland, OH 44115-2214

Campus Location
Keith Building, Room 1150
1621 Euclid Avenue

Phone: 216.687.3910
Fax: 216.687.3965
cispcsu@csuohio.edu

Web Content Contact
Natkamol Tayarachakul
n.tayarachakul@csuohio.edu

Web Technical Contact
d.arthur91@csuohio.edu

Health Insurance Waiver


Waivers from the University health care policy are limited to:

A. Students sponsored by the U.S.Government, their home country, or a non- governmental      organization (such as the UN) which as a part of the scholarship provides health insurance.

B. Students who have coverage through a parent's work, a spouse's work, or their work.      (Must submit statement that medical expenses will be covered while in the U.S. and policy      must include Repatriation Coverage of $10,000 and Medical Evacuation Coverage of      $15,000).

C. Students presently insured with a U.S. health insurance company receiving benefits due to      an ongoing illness or accident. (Must provide proof that you have a need to stay with that      company and policy must include Repatriation Coverage of $10,000 and Medical      Evacuation Coverage of $15,000).

THE POLICY MUST ALSO MEET THE CSU REQUIREMENTS STATED ON THE HEALTH INSURANCE VERIFICATION FORM AND BE SUBMITTED BEFORE DEADLINE. A new Health Insurance Verification Form must be filled out each academic year you wish to waive. Students who fail to fill out a new form academic year will be charged for the University's Health Insurance policy.

To Decline coverage under the Student Health Insurance Plan and avoid the charge to your account, you must:
  1. Make a copy of your insurance card and policy.
  2. Fill out a health insurance verification form.
  3. Return the form with the copy of your insurance card and policy to KB 1150
  4. To avoid the insurance charge, be sure you do not miss the deadline!
DEADLINES FOR HEALTH INSURANCE WAIVERS
Continuing students and students starting in Fall only need to waive once a year. Students will only have to waive insurance in August and the waiver will be effective for the entire Academic year!

Download Health Insurance Verification Form in PDF format here.



CSU | Health Insurance | CISP

Cleveland State University   •   2121 Euclid Avenue, Cleveland, OH 44115-2214   •   216.687.2000
This page last modified Thursday, April 24, 2008