Health Insurance Acceptance/Waiver Form
Completed Health Insurance Acceptance/Waiver Form. If Loyola’s health insurance is not purchased, a summary of benefits (in English) must be submitted to Loyola. Loyola will review and determine whether or not the alternate health insurance plan meets the minimum coverage requirements.* Once an alternate health insurance plan is approved by Loyola, students must submit proof of coverage with validity throughout the length of the student’s stay in the United States. A copy of the front and back of insurance card must be presented.
Completed Health Form and Immunization Record signed by both doctor and student. The student’s healthcare provider/physician must provide accurate and legible information on the form prior to the student’s arrival at Loyola. If the student’s immunizations are not up-to-date, the student will have to receive updated immunizations in the United States for a fee. Please read the Immunizations at Loyola handout for a list of required immunizations.
*Note: The health insurance plan review may take up to 3 weeks for processing, therefore, please plan accordingly.