Coverage Requirements

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 Coverage Requirements (.pdf). 

Coverage dates

Your coverage must be valid for the plan year beginning August 1, 2024 through July 31, 2025 (or beginning July 1, 2024 if you are an FSI program participant).  

Plans Not Accepted for SHP Opt-Out

  • HMO’s and Kaiser plans, Medicaid, Medicare, and 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
  • Plans that exceed the annual out-of-pocket maximum of $9,450/individual plan or $18,900/family plan (per Affordable Care Act, as of 2024)
  • Any other plan that does not meet the coverage requirements listed below

If you have an ineligible plan, you are required to enroll in the Student Health Plan. Financial aid is available to aid-eligible students if your plan does not meet the coverage requirements. Contact the Financial Aid Office at 609-258-3330 or [email protected].

2024-2025 Plan Coverage Requirements

Your plan must include:

  • In-Network coverage in the Princeton, NJ area and the NJ region
  • In-Network or Out-of-Network coverage throughout the United States
  • Coverage while traveling abroad
  • 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
  • laboratory services and radiology
  • prescription medications
  • medical evacuation, repatriation, and ambulance expenses