You May Be Paying Thousands a Year — and You Might Not Have To
Most US universities automatically enroll international students in a Student Health Insurance Plan (SHIP) and charge it to the tuition bill — at the 99 of 100 schools in our waiver dataset that publish a premium, the median is about $3,679/year (2026–27). At most schools you can waive this charge if you have comparable coverage from another provider. Private student plans start at $33/month (ISO Silver, ages 12–24) — but only the plans and tiers your school accepts will save you money.
This guide walks you through every step of the waiver process: what SHIP is, what requirements your alternative plan must meet, how to submit the waiver, what to do if it’s denied, and which plans international students commonly use to qualify.
For a full overview of health insurance in the USA, see our USA country guide.
What Is SHIP and Why Is It So Expensive?
A Student Health Insurance Plan (SHIP) is a group health insurance plan sponsored by your university. It is designed to be ACA-compliant, cover mental health, include a broad local network, and require no underwriting — meaning no one is denied based on pre-existing conditions.
That comprehensive design comes with a price. Student-only SHIP premiums at major US universities for 2026–27 (checked 30 September 2026):
| University | Annual SHIP Cost |
|---|---|
| Stanford University | $8,808/year |
| UC Berkeley | $5,066–$8,206/year |
| Columbia University | $5,823–$7,248/year |
| Harvard University | $4,954/year (plus a separate $1,944 health fee) |
| Penn State University | $4,365–$5,295/year |
| University of Maryland | $2,939/year |
Most universities auto-enroll you and add the premium to your semester bill. If you do nothing, you pay. The waiver process is how you opt out.
Can International Students Waive SHIP?
Yes — in most cases. Most US universities allow F-1 and J-1 visa holders to waive SHIP if their alternative plan meets the university’s coverage standards.
There are important exceptions:
- Some universities do not allow waivers for international students at all — 18 of the 100 schools in our dataset, including Cornell, Johns Hopkins, Duke and Tulane.
- J-1 visa holders must always meet the federal minimums ($100,000 medical, $50,000 evacuation, $25,000 repatriation, max $500 deductible; co-insurance up to 25%) regardless of whether they also waive SHIP.
- A handful of programs (some medical, law, and dental schools) mandate SHIP with no waiver option.
Always check your specific university’s waiver policy before purchasing an alternative plan.
What Requirements Must Your Plan Meet?
Requirements vary by university, but the following thresholds appear across most major institutions. Your alternative plan typically must have:
| Requirement | Typical Minimum |
|---|---|
| Annual benefit maximum | Unlimited or $1,000,000+ |
| Annual deductible | $500 or less per person |
| Out-of-pocket maximum | At or below the ACA limit for an individual |
| Mental health coverage | Yes, parity with medical |
| Preventive care | 100% (ACA-compliant) |
| Medical evacuation | $50,000+ (especially J-1) |
| Repatriation of remains | $25,000+ (especially J-1) |
| US-based insurer | Required at many universities |
| In-network US providers near campus | Required |
| Prescription drug coverage | Yes |
The “US-based insurer” requirement is a common reason waivers are denied for international students. Plans issued by foreign insurance companies — even if they cover you in the USA — often fail this criterion. Always verify whether your plan’s underwriter is a US-licensed carrier.
Step-by-Step: How to Submit a Waiver
Step 1: Find your university’s waiver portal
Go to your university’s student health insurance office website. Search for “[University name] SHIP waiver” or “[University name] health insurance waiver.” Most universities use one of a handful of third-party platforms (Gallagher Student Health, Wellfleet, United Healthcare Student Resources).
Step 2: Check the waiver deadline
Deadlines are strict — and they differ a lot between schools. Typical windows:
| Semester | Typical Waiver Deadline |
|---|---|
| Fall (August/September start) | From July (Harvard: 31 July 2026) to late September (NYU: 30 September 2026) |
| Spring (January start) | From December to February (Harvard: 31 January 2027; University of Maryland: 15 February 2027) |
More examples for 2026–27:
- University of Maryland: Fall 2026 deadline 1 September 2026
- Yale University: Fall 2026 deadline 15 September 2026 — no late waivers
- USC: Spring 2027 deadline 29 January 2027
If you miss the deadline, you are usually enrolled and charged for the term; a few schools accept late waivers for a fee (UC Berkeley until 15 August 2026 with a $75 fee). Mark the date in your calendar the moment you get your offer — some deadlines fall before you arrive.
Step 3: Gather your documents
You will typically need:
- Your insurance ID card (front and back)
- Proof of coverage dates (must cover the full academic year)
- Your policy’s Summary of Benefits and Coverage (SBC)
- Your insurer’s name, policy number, and customer service phone number
Step 4: Complete the online waiver application
Log in to the waiver portal with your student credentials. Enter your insurance details and answer questions about your coverage. Some universities use automated verification systems that check your plan against their requirements in real time.
Step 5: Wait for confirmation
Processing times differ by school. You will receive an email approval or denial. If approved, the SHIP charge is removed from your student account. Keep the confirmation email.
Step 6: Re-submit every year
At most schools, waivers are not automatic. You must re-submit every academic year, and some universities require re-submission every semester.
Alternative Plans That Commonly Qualify
These plan types are most frequently accepted for SHIP waivers:
ACA Marketplace Plans (Healthcare.gov)
- Cost: Full premium for most F-1 students (no subsidies) — varies by plan, age and state
- Pros: Fully ACA-compliant, meets the criteria of schools that require ACA-level cover, broad US networks
- Cons: Open enrollment is once a year; special enrollment requires a qualifying life event
- Verdict: Best option if you qualify for a special enrollment period when you arrive
Employer-Sponsored Plans (Parent or Spouse)
- Cost: Covered by employer, student pays dependent premium
- Pros: Almost always accepted — these are US-based group plans
- Cons: Must verify dependent coverage extends to you as an international student
- Verdict: If a parent or spouse has US employer coverage that includes you, this is the easiest path
International Student Insurance Plans
These plans are specifically designed for international students in the USA and marketed as waiver-eligible. Acceptance varies significantly by university.
| Provider | Price (as of October 2026) | Notes |
|---|---|---|
| ISO Student Health Insurance | From $33/month (Silver) to $87/month (Platinum), ages 12–24 | Aetna PPO; Silver’s $400,000 annual maximum fails strict schools |
| WorldTrips StudentSecure | From $40/month (Smart) to $204/month (Elite), under 25 | $0 deductible; all tiers meet J-1 rules |
| Compass Student Insurance | From $43/month (Savings) to $123/month (Benchmark) | Benchmark is ACA-comparable; refund if your school rejects the plan and you made no claim |
| IMG Patriot Exchange Program | From $51.20/month | Designed for F-1/J-1 and dependants; J-1-compliant from the $100,000 option |
Important: Some schools set much stricter rules. The University of Michigan, for example, requires an ACA-compliant plan from a licensed US carrier with a deductible of $100 or less, and explicitly does not accept ISO, PSI and several other international student plans. Always check your university’s criteria before buying.
State Medicaid
- Eligibility: F-1 and J-1 students are generally not eligible for Medicaid (at most for emergency Medicaid)
- Cost: Not relevant for most international students
- Verdict: Not a realistic waiver option — plan for a SHIP or a private plan your school accepts
What If Your Waiver Is Denied?
A denial doesn’t have to be final. Here’s what to do:
Reason 1: Your insurer is not US-based
Buy a supplement or switch to a US-licensed plan. Contact your university’s insurance office about which specific carriers they accept.
Reason 2: Your deductible is too high
Some plans let you purchase a deductible buy-down rider. Otherwise, you’ll need to switch to a lower-deductible plan.
Reason 3: Missing mental health parity
ACA-compliant plans in the US must cover mental health equally to physical health. If your plan excludes or limits mental health benefits, it will fail this check.
How to appeal
- Request the denial reason in writing — this is your right
- Contact the insurance office directly — ask what specific criterion your plan failed
- Submit a formal appeal with additional documentation (e.g., a letter from your insurer confirming US-based underwriting or specific benefit details)
- Timelines: Appeal deadlines are short — check your school’s rules as soon as you receive the denial
- Escalate to your international student office (ISO/DSO) if the university insurance office is unresponsive
If your appeal is denied and you cannot find a qualifying plan, you will be enrolled in SHIP for that semester.
Is SHIP Ever Worth Keeping?
Yes — in several situations:
Keep SHIP if:
- Your alternative plan has a significantly higher deductible (e.g., $2,000 vs. SHIP’s $500)
- You have a chronic condition requiring regular specialist visits or prescriptions — SHIP often has better in-network provider access near campus
- Your university’s student health center works best with the SHIP (some bill only the SHIP directly)
- You’re in a high-cost city (NYC, San Francisco, Boston) and your alternative plan’s network is thin
- Your SHIP also covers dental and vision — compare total value, not just premiums
Consider waiving if:
- You are young and healthy and want catastrophic coverage only
- A parent or spouse’s US employer plan includes you at low or no extra cost
- You can get a solid plan your school accepts for clearly less than the SHIP
- You’re only enrolled part-time or for one semester
What Cheaper Plans Don’t Cover — Risk Awareness
Before you waive, understand the trade-offs:
| Gap | What it means in practice |
|---|---|
| Narrow US network | Out-of-network bills can be very high even with insurance |
| High deductible ($1,000+) | You pay the first $1,000 of every illness or injury |
| No mental health parity | Therapy sessions not covered or capped |
| No maternity | A US delivery without coverage is very expensive |
| No prescription coverage | Specialty drugs in the US can be very expensive |
| Short-term plan limits | Many short-term plans exclude pre-existing conditions entirely |
A cheap plan may save you thousands in premiums — but one hospitalization can cost far more if the plan is inadequate.
Frequently Asked Questions
Can I use travel insurance to waive SHIP? No. Travel insurance is not health insurance and does not meet waiver requirements. It typically excludes pre-existing conditions, has low coverage caps, and is not ACA-compliant.
What if I miss the waiver deadline? You are usually enrolled in SHIP for that term. Some schools accept late waivers for a fee within a short late period (e.g. UC Berkeley, Harvard); others don’t (e.g. Yale). If your enrollment status changes (for example dropping below the threshold for SHIP eligibility), contact the insurance office.
Do I need to re-submit the waiver every year? At most schools, yes. Waivers are usually academic-year specific: many universities require a new submission every fall, and some require one each semester.
Can I waive SHIP with my home country’s national health insurance? Almost certainly not. National health plans from Germany, France, Canada, etc. do not have US provider networks and are not US-licensed carriers. They will fail the waiver test.
Is there a penalty for not having insurance in the USA as an F-1 student? There is no federal tax penalty for F-1 students (the ACA individual mandate penalty was effectively eliminated in 2019 at the federal level). However, your university may prevent course registration or graduation if insurance requirements are not met.
My SHIP was approved but the charge is still on my bill — what do I do? University billing systems can take a while to reflect waiver approvals. Contact the student accounts office with your waiver confirmation number if the charge isn’t removed before your payment is due.
Can I waive SHIP mid-semester? Usually not. Waivers must be submitted during the designated waiver period of each term — check your school’s deadlines.
Is ISO or PSI accepted at my university? It depends entirely on your specific university — some schools, such as the University of Michigan, explicitly reject them. Providers such as ISO list schools that have accepted their plans, but always verify with your school before purchasing.
What’s the difference between waiving and opting out? They’re the same thing — “waiving” and “opting out” both refer to the process of removing the SHIP charge from your bill by demonstrating comparable coverage.
Can a denied waiver affect my visa status? No. Waiver decisions are administrative, not immigration decisions. However, J-1 visa holders must maintain coverage that meets the federal J-1 minimums (22 CFR 62.14) regardless of SHIP enrollment status.
Related Articles
- Student Health Insurance in the USA: Complete Guide
- F-1 Visa Health Insurance Requirements
- OPT & CPT Health Insurance Gap for F-1 Students
Compare Plans Now
Not sure which plan qualifies for your university’s waiver? Use our comparison tool to filter by coverage level, price, and waiver eligibility — or jump straight to our reviewed USA student health insurance plans (ISO Student Health Insurance, IMG Patriot Exchange Program, WorldTrips StudentSecure, Compass Student Insurance) — check each tier against your school’s waiver criteria.
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