Insurance Forms

Note, the Health Fee Waiver application is not available here. The waiver application is only available on-line through the Health Fee Waiver Tool in the TritonLink Toolbox. Read more about the waiver.

Exception to Closed Enrollment form (PDF)
Electronic Medical Claims - sign up today! (PDF)
How to access your 1095-B tax form (PDF)
Insurance Confidentiality (PDF)
No Show Billing Dispute form (PDF)
Retro Referral Appeals (PDF)
Waiver Cancellation Form (PDF)

Want to better understand your health insurance?

Join us for the UC San Diego Health Insurance Requirement & Access to Care on Campus Webinar Series. Discover everything you need to know about insurance requirements, UC SHIP, the health fee waiver process, RAFT, and accessing Student Health Services.