Health Insurance Aid Request

All students are required to have comprehensive health insurance coverage.

You must notify the Student Health Insurance Office annually of your coverage. You are required to either be covered through the university plan (NU-SHIP) or waive the coverage because you already have a comparable insurance plan. For details, refer to the Student Health Insurance Office website or email student.insurance@northwestern.edu.

The Undergraduate Financial Aid office provides aid to undergraduate students with significant financial need who must purchase the university plan. This aid is available only to undergraduate students.

Upon receipt of this form, our office will review your eligibility for health insurance assistance. The aid provided will depend on your financial need as determined through the financial aid application process. If approved, this adjustment will appear on your invoice as a direct credit against the charge of the NU-SHIP plan. Please note, this request cannot be considered until the insurance charge appears on your university invoice.

Student Name Student Name First Last
Student ID Number
Northwestern Email Address

Confirm Email Address
Student Certification
By submitting this form, I affirm that I am an undergraduate student and do not have comparable health insurance available during the academic year. I therefore request consideration for additional financial aid to cover the cost of the NU-SHIP insurance plan.

By submitting this form, I affirm that I am an undergraduate student and do not have comparable health insurance available during the academic year. I therefore request consideration for additional financial aid to cover the cost of the NU-SHIP insurance plan. I affirm.
Submission Date Submission Date / MM / DD YYYY

Health Insurance Aid Request

Health Insurance Aid Request

Student Certification