What Is a Health Insurance Waiver?

Opting out of health insurance coverage with Health Insurance Waivers
Photo: Blend Images - Colin Anderson / Getty Images
Definition

A health insurance waiver is a document that when signed provides the option to opt out of a health insurance plan offered to you by making a formal request.

Key Takeaways

  • You may have to sign a health insurance waiver every year to acknowledge that you have been offered healthcare but have chosen not to get it.
  • You may want to use a health insurance waiver when you get your health insurance through another source, such as through a spouse.
  • If you don't have another way to get health insurance, you may want to consult your HR department about whether it's in your best interest to waive insurance.

How Does a Health Insurance Waiver Form Work?

A health insurance waiver form will usually contain information regarding your request to waive access to a health insurance plan being offered to you. The health insurance waiver form will include your declaration that you have been offered a plan, however, have chosen to refuse the health insurance coverage being offered to you.

Note

Waiving health care benefits may make you ineligible for subsidized healthcare under the Affordable Health Care Act.

Employer-sponsored health insurance plans can be a significant advantage for employees, especially when the employer pays for part or all of the health insurance coverage. However, there are times when a person may not need the medical plan from their employer. 

In other instances, an employer may offer medical waivers as part of an employee benefits package. If an employee chooses a medical waiver they could receive an extra yearly payment that would be a percentage of what the company pays for the employee's insurance coverage.

Proof Requirement

Depending on the organization or reason for your health insurance waiver request, you may also be required to provide proof of the reason that you wish to waive health insurance benefits. This is for the protection of the organization, company, or school that is offering you the plan.

The organization may want to verify that you have adequate health insurance elsewhere before approving your health insurance waiver request. Health insurance waivers may have to be signed on an annual basis, and if your situation changes, it may become part of your agreement that you advise your plan provider.

College or University Health Insurance Plans

Universities tend to have health insurance waiver opportunities. Students already enrolled in equal or better health insurance plans than the one offered by their college or university usually have the option to waive the health insurance by filling in a health insurance waiver form and providing proof of comparable coverage elsewhere. The deadlines for submitting these waivers correspond with school terms.

Note

This is a popular option for students since they are often covered by a family plan, and the cost savings of waiving health insurance can amount to thousands of dollars a year.

What To Consider Before Opting Out

Carefully read the waiver to make sure you understand what you are signing off on. A health insurance waiver usually applies to the person signing the waiver and their dependents. You cannot pick and choose who will be covered or waived.

Pay particular attention to any clauses which relate to changes of circumstance. Some waivers include a clause that gives you a 30-day window to enroll after a major change in circumstance.

Major changes that reopen the application window could include:

  • Pregnancy, adoption, or birth
  • Change of spouse or parent's employment benefits
  • Death of a dependent or spouse
  • Marriage, legal separation, or divorce
  • Gain or loss of employment or loss of eligibility for coverage due to a reduction in hours or leave of absence or layoffs

Note

You may not have the opportunity to reapply for a group benefits plan if you initially waive coverage. Check with your plan administrator for more information.

Examples of Requesting a Health Insurance Waiver

There are many reasons you may decide that you want to waive your health insurance coverage, but before you do, it is always a good idea to look into the advantages of dual coverage or coordination of benefits. Sometimes it is more beneficial to take advantage of multiple plans if you have a lot of medical costs or specific needs. Always explore all your options.

For example, you might want to waive coverage if your employer health insurance plan or student health insurance plan is not required because you already have insurance through another plan. For example, if your spouse has a health insurance plan that already covers you, you might request a health insurance waiver. You do not need the coverage your school or employer is offering you since you are already insured elsewhere.

Some other situations in which you might seek a health insurance waiver include:

  • If you are eligible for a plan that meets minimum essential coverage (MEC) requirements in the Affordable Care Act
  • If you are covered by your parents' health insurance plan
  • If you are already covered or eligible for services through an Indian Health Services provider
  • If you are a member of a religious sect with objections to insurance

Saving Money or Gaining Income With Health Insurance Waivers

The health insurance waiver is sometimes viewed as an employee benefit because by waiving insurance, some employers have offered to compensate the employee for the financial value of the cost of insurance. However, most employers do not pay the entire cost of coverage, so there isn't as much of an incentive to avoid extending those benefits.

Signing a health insurance waiver may not provide any advantage regarding your employee benefits in the form of a salary "increase" anymore since many employers do not pay for their employees' health insurance benefits like they used to.

However, the waiver may still reduce the costs of deductions from your payroll for your insurance since you will be covered under an alternate plan and not paying into the employer plan.

Note

Jim and Tina are a couple, and both partners work. Jim chooses the health insurance waiver from his job since he is covered under Tina's employer-sponsored health insurance plan. In return, his employer gives him an additional $3,000 per year, also known as an "opt-out buyback."

The Bottom Line

The decision to waive health care benefits from an employer or other organization is significant. You want to make sure you are protecting your best interests and analyzing all your insurance options to choose the best coverage.

Be sure and review the specific details of how your employer-sponsored benefit plan would cover you, how much it would cost, and what advantage if any you might get if you sign a health insurance waiver before you waive your right to the health insurance plan. Your HR department or student services department or health plan administrator would be in the best position to outline costs and benefits for you.

Frequently Asked Questions (FAQs)

How do I waive student health insurance?

The paperwork your university sends you to sign up for a health insurance plan will usually include a waiver form as well. If you do not need health insurance through your school, you can sign the form and send it back with your other paperwork. You may need to provide proof that you are covered under another insurance plan.

How long does an insurance waiver take?

How long it takes to process your health insurance waiver will depend on the company handling your application. A processing time of one to two weeks is common. If you fill out your forms online, these will often be processed more quickly than forms you mail in.

Can I take back a health insurance waiver?

If you waive health insurance because you are covered under another plan, but then lose that coverage, you may be able to submit an application to rescind your waiver. The time frame for doing that, and whether it is allowed at all, will depend on the program offering the insurance plan.

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Sources
The Balance uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. City of Milwaukee Department of Employee Relations. "Waiver: Health and/or Dental Coverage," Page 1.

  2. Harvard University. "Waiving Health Insurance Coverage."

  3. Centers for Medicare & Medicaid Services. "Minimum Essential Coverage."

  4. Bureau of Labor Statistics. "Employee Benefits in the United States — March 2022," Page 11.

  5. Harvard University Student Health Program. "Waiver FAQs."

  6. University of Massachusetts Amherst University Health Services. "Waiving the SHPB."

  7. CSU Health Network Colorado State University. "SHIP Waiver Process - Frequently Asked Questions."

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