Comparable Coverage Criteria

To Opt-Out of the Princeton University Student Health Plan (SHP), a student’s private insurance/health plan coverage must meet specific criteria while at Princeton University and throughout the United States.

To determine if you plan is eligible for Opt-Out, review the Comparable Coverage Criteria requirements(.pdf). 

Coverage dates

Your coverage must be valid for the plan year beginning August 1, 2023 through July 31, 2024 (or beginning July 1, 2023 if you are an FSI program participant).  

Plans Ineligible for Opt-Out

  • HMO’s and Kaiser plans, Medicaid/Medicare/Medi-Cal, traveler’s plans, plans that are not issued in the United States or do not have a U.S.-based claims administrator/telephone number/address, and plans that require referral from a Primary Care Physician
  • Plans that exceed the annual out-of-pocket maximum of $9,100/individual plan or $18,200/family plan (per Affordable Care Act, as of 2023)
  • Plans that do not meet all of the coverage requirements as outlined below

If you have an ineligible plan, you are required to enroll in the Student Health Plan. Financial aid may be available. Please contact the Financial Aid Office at 609-258-3330 or [email protected].

2023-2024 Plan Coverage Requirements

Your plan is required to provide in-Network coverage in the Princeton, NJ area and coverage throughout the United States for the following essential health benefits:

  • emergency, non-emergency, routine and preventive medical care, and hospitalization (inpatient and outpatient)
  • mental health care and substance use disorders (inpatient and outpatient)
  • prenatal and postnatal maternity care, newborn care, and pediatric care/services
  • athletic injuries resulting from practice or play on a sports team
  • pre-existing conditions
  • chronic disease management
  • laboratory services and radiology
  • rehabilitative and habilitative services and devices
  • prescription medications
  • medical evacuation, repatriation, and ambulance expenses