2025 Fall Waiver Deadline
Coverage Dates
September 30th*
8/21/25 - 8/20/26
*This is the final deadline for submitting the
waiver form, not applying for external insurance.
How to waive
1. Fill out the attached waiver form
We have pre-filled a waiver form for
you. Please fill in the remaining fields
prior to sending the waiver form back
to your institution.
The Member ID can be found on your
insurance card or you can check the
digital card for your member ID.
2. Draft an email to
health.insuranceattestation@nyu.edu
using the sample email below.
Attach images of both the front and
back of your health insurance card.
If you have not yet received your
physical card, you will receive a
confirmation email upon purchasing
the Violet Exclusive or Royal Series
insurance plan.
How to waive
In the email, you should also:
Attach a completed waiver form.
Please download the Waiver Form
below, fill in your information, and
send it back to NYU.
Click to download Waiver Form
How to waive
Here is a template of the email for your
reference:
Hi,
My name is xxxx, and my university ID is
Nxxxxxx.
I am writing to submit my request for
waiving the NYU health insurance.
I have attached the completed waiver form
and my insurance card to this email.
And my insurance ID is xxxxx.
Please let me know if you have any
questions or need any additional
information. Thank you so much in
advance, and I am looking forward to
hearing from you soon.
Best regards,
Your Name
：
Waiver Form Instruction
You only need to fill in the information within the red
box. Except for the signature which needs to be handsigned, you can print or type the other information.
08/21/2025
08/20/2026*
*NYU requires coverage from August 21, 2025, to August 20, 2026.
As shown in the example, the alternative insurance purchased must cover these dates.
The waiver form provided above is for personal use only and should
not be shared with others. Anyone found violating this may be held
legally responsible. Thank you for your cooperation.