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Waiver Criteria

All domestic students enrolled in 6 or more credit hours and all international students enrolled in 1 or more credit hour will be automatically enrolled in the WVU Aetna Student Health Insurance Plan – this applies to both on-campus and online students. Any student who is already covered by another health insurance plan that meets the requirements below may complete the insurance waiver application by the published deadline to opt out of the WVU-sponsored student health insurance plan.

Waiver Criteria

In order to opt out of the WVU Aetna student health insurance plan, your current plan must meet the following criteria:

Domestic Student Waiver Criteria:

  • Provides in-patient and out-patient medical care coverage in West Virginia (coverage for emergency only care in WV does not satisfy this requirement);
  • Provides in-patient and out-patient mental health and substance abuse care in West Virginia;
  • Provides pharmacy coverage;
  • Is not a Medicaid plan provided by any state other than West Virginia;
  • My plan is currently active, and I agree to maintain health insurance coverage throughout the entire 2023-2024 academic year. If you should lose your current coverage you are required to notify the WVU Student Insurance Office as you are required to maintain comparable coverage while enrolled in 6 or more credit hours.

Note: Catastrophic plans and Medicaid plans that do not provide coverage in the state of West Virginia will not satisfy these criteria.

International Student Waiver Criteria:

In order to opt out of the WVU Aetna student health insurance plan, your current plan must meet the following criteria:

  • Provides in-patient and out-patient medical care coverage in West Virginia (coverage for emergency only care in WV does not satisfy this requirement);  
  • Provides in-patient and out-patient mental health and substance abuse care in West Virginia;
  • Is expected to be in force for the entire academic year; 
  • Provides in-patient and out-patient coverage in your campus area;  
  • Provides pharmacy coverage;  
  • Has a U.S.-based claims address;
  • Annual individual out-of-pocket maximum is not greater than $7,350; 
  • Provides at least $1,000,000 per accident or illness in coverage payable in U.S. Dollars; 
  • Provides coverage for pre-existing conditions if the member has prior creditable coverage and does not rider or exclude coverage for pre-existing conditions. 
  • Provides at least $25,000 coverage for Repatriation & at least $50,000 coverage for Medical Evacuation (repatriation provides transportation to your home country in the event of death; medical evacuation is emergency transportation to the nearest, most qualified treatment facility) 
  • Is not a Medicaid plan provided by any state other than West Virginia;
  • My plan is currently active, and I agree to maintain health insurance coverage throughout the entire 2022-2023 academic year. If you should lose your current coverage you are required to notify the WVU Student Insurance Office as you are required to maintain comparable coverage while enrolled in 1 or more credit hour(s).

Note: Catastrophic plans, travel policies, policies without a US based claims office and Medicaid plans that do not provide coverage in the state of West Virginia will not satisfy these criteria.

Other Required Information

To complete the waiver form, students will need to provide information about their current health insurance policy, including:

  • Insurance company name  
    (ex. Blue Cross Blue Shield, Aetna, Cigna, PEIA, etc.)
  • Policy number
  • Insurance company phone number and claims address
  • Policy holder name and date of birth
  • Policy holder ID

Definitions

What does “hard waiver” mean? 
The term “hard waiver” means that any eligible student enrolled in six or more credits is required to show evidence of coverage under an existing health insurance policy OR enroll in the University-sponsored health insurance plan.

“Hard waiver” does not mean a student must enroll in the University-sponsored health insurance plan; it means a student must show evidence of adequate coverage by an acceptable health insurance plan if they would like to opt out of the WVU-sponsored plan.

Audits

Students will be required to provide their health insurance policy information as part of the waiver form. Random audits will be completed to ensure that plans meet these minimum requirements. Waiver applications for insurance plans which DO NOT meet the minimum requirements will be denied and student will be required to purchase the WVU student insurance plan.  

Waiver submissions may be audited by West Virginia University, Aetna Student Health, and/or their contractors or representatives. You may be required to provide, upon request, any coverage documents and/or other records demonstrating that you meet the school’s requirements for waiving the student health insurance plan. By submitting the waiver request, you agree that your current insurance plan may be contacted for confirmation that your coverage is in force for the applicable policy year and that it meets the school’s waiver requirements.  

If your waiver request has been denied for any reason, you may submit a written appeal directly to the WVU Student Insurance Office for review. Please include copies of your current insurance plan information, any correspondence with Aetna Student Health, and any additional materials you have relevant to your case.