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This document is the enrollment application for the Vanderbilt University Student Injury and Sickness Insurance Plan for the period from June 1, 2011, to August 11, 2011. Eligible medical students
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How to fill out Vanderbilt University Student Injury and Sickness Insurance Plan Enrollment Application

01
Obtain the Vanderbilt University Student Injury and Sickness Insurance Plan Enrollment Application form from the official university website or the student health office.
02
Fill in your personal information at the top of the form, including your name, student ID, and contact details.
03
Indicate your status as a full-time or part-time student.
04
Provide information regarding your previous insurance coverage, if applicable.
05
Select the appropriate coverage period for your insurance plan based on your enrollment dates.
06
Review any additional options or riders available to enhance your coverage, if desired.
07
Sign and date the application to certify the information provided is accurate.
08
Submit the completed application form via email or in person to the designated office for processing.

Who needs Vanderbilt University Student Injury and Sickness Insurance Plan Enrollment Application?

01
Students enrolled in Vanderbilt University who wish to have health insurance coverage while studying.
02
Students who do not have existing health insurance that meets the university's requirements.
03
International students who may need specific coverage while studying in the U.S.
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The Pre-Dental Society Vanderbilt University (PDSVU) is devoted to providing educational, support, and volunteer opportunities for all pre-dental students on campus.
Eligible dependents include a student's married spouse or a child (under the age of 26). Domestic partners (same sex or opposite) are not covered. It is the insured student's responsibility to enroll eligible dependents each year. Dependents are not automatically re-enrolled.
Dental Coverage All students under the age of 19 are covered under UHC's pediatric dental plan. International students and graduate students in GDOCL and GMFA programs are also automatically enrolled in MetLife Dental coverage.
Vanderbilt General Dentistry offers a full range of dental care for adults and children. At any stage of life, it's important to practice good oral hygiene and visit the dentist regularly. Starting early helps preserve a healthy smile for a lifetime.
Health insurance may cover dental work if it's connected to an emergency or a medical condition. You must buy a dental insurance policy to cover dental care like preventive care, fillings, X-rays, dental implants and root canals.
Dental Coverage Prophylaxis (cleanings): Plan pays 100% for one treatment every six months. Oral Examinations: Plan pays 100% after a $50 Individual Deductible for one exam every six months. Amalgam Fillings: Plan pays 80% for In-Network Providers after a $50 Individual Deductible.
Academic HealthPlans (AHP) Support Services AHP is the plan administrator for SHIP. AHP offers a customer service team and live chat to help answer your SHIP insurance questions. Visit the Help Center to submit a help request or initiate a live chat. You may also call 1-855-855-2486.

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The Vanderbilt University Student Injury and Sickness Insurance Plan Enrollment Application is a form that students must complete to enroll in the university's health insurance plan, which provides coverage for medical expenses related to injuries and sickness.
Students who are not covered by an alternative health insurance plan, or who wish to enroll in the Vanderbilt University insurance plan for the academic year, are required to file this application.
To fill out the application, students should provide personal information such as name, student ID, and contact details, along with any required health information and signatures as instructed in the form.
The purpose of the application is to collect necessary information to enroll students in the health insurance plan, ensuring that they receive adequate medical coverage during their time at the university.
Students must report personal information, including their full name, student ID, contact information, and any existing health insurance details, as well as any relevant medical history if required.
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