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Waiver Appeals

How To File An Appeal

If you submitted a waiver and your waiver application was denied, you may file an appeal if you feel you made an errorPlease read all of the instructions below before filing an Appeal: If your Waiver Application was denied because you missed the waiver application deadline, DO NOT FILE AN APPEAL. 

Appeals will not be considered for students missing the waiver deadline. 

Your appeal must be submitted online through the secure login portal below to the Insurance office within seven (7) days of the date of notice of denial. Appeals received after the (7) day grace period will Not be considered.

Appeals will be considered for the current semester only. Waivers granted on appeal will NOT be applied to any previous semester. 

Failure to complete the entire Waiver Appeal form, or to provide appropriate documentation, will result in your appeal being denied. You will remain enrolled in UCSHIP for the appropriate semester and be responsible for all UCSHIP fees. 

Evaluation of your Appeal will be based on comparability insurance guidelines in effect at the time of the original Waiver Application.


Required Documents you MUST submit to File a Waiver Appeal

  • Attach the completed Waiver Appeal Form PDF

  • Attach copy of Waiver Denial Notice. (PDF)

  • Attach copy of front and back of current insurance card. (PDF)

  • Attach copy of the Complete Insurance Benefit Summary (this can be found online at your insurance company’s website by making a user name and password login or by calling your insurance company). (PDF)

Waiver Appeal documents must ALL be sent in (PDF) format.

You must initial ALL spaces on the second page where it states to initial. DO NOT PUT AN X.

You Must sign and date your Waiver Appeal or it will be denied as incomplete.


Example of an Insurance Card for Merced County Central California Alliance.


No action will be taken on your appeal without all of the above attachments.

Communication regarding the status of your Waiver Appeal will be sent to your UC Merced email address. 

Please only submit your Waiver Appeal one time. Once we receive your appeal we will send an email confirmation.


If you still want to file a Waiver Appeal, download the Waiver Appeal Form PDF and submit the completed form and the required documents below within seven (7) days of the date you received the notice of your waiver denial.


Disclaimer: Submission of an appeal is not a guarantee of an approval.