Insurance Forms
Mid-Year Changes / Cancellations
Leaves of Absence
- 2022-2023 NU-SHIP Enrollment Form for Students on a Leave of Absence (pdf) - used by students on a leave (Medical, Parental, other) during Fall quarter, to renew their NU-SHIP coverage for the academic year.
Aetna Forms
- Medical Benefits Claim Form
- Prescription Drug Claim Form
- Medical Exception/Prior Authorization/Precertification Request for Prescription Medications
- Member Complaint and Appeal Form
Plan Comparison
- 2022-2023 Comparable Coverage Checklist (pdf) - 1-page summary of Northwestern's requirements for all insurance plans for the academic year (provides required criteria to waive NU-SHIP enrollment).
Financial Aid
The financial aid office provides aid to undergraduate students who need to purchase the university plan and who also have significant financial need. The aid provided will depend on your financial need as determined through the financial aid application process. Please complete the 2022-23 Health Insurance Aid Request application. This application is processed by the Office of Financial Aid. Please follow-up with them on the status of the application after it is submitted.