All UHIP applications

Name Name * First Last
Student Number *
Must be 9 digits. Currently Entered: 0 digits.
If you are a visiting scholar/researcher or temporary international faculty, you can indicate the student number as 000000000.
Email *
Please select the option that applies to you. *

Please select the option that applies to you. Adding or renewing dependent coverage Applying for UHIP as a Visiting Scholar/temporary international faculty Applying for UHIP as an IVRT Applying for UHIP extention after graduation Applying for UHIP for my semester off (medical, non-medical, maternity or paternity leave of absence) Applying for UHIP as an MBA student who is taking Fall semester off instead of Summer.

If you select the incorrect option, please refresh the page before selecting the correct option.

For example, if you want to renew your dependent but you selected "extending my UHIP after graduation" in error, please refresh the page and then select "Adding or renewing dependent coverage".
Has your dependent been added under UHIP before?

NOTE: You can only add new dependents if they are here in Canada. Please do not submit the application if your dependent is not yet here.

Please not that dependents cost $63 a month in addition to your own UHIP charges

Has your dependent been added under UHIP before?

NOTE: You can only add new dependents if they are here in Canada. Please do not submit the application if your dependent is not yet here.

Please not that dependents cost $63 a month in addition to your own UHIP charges Yes, I would like to renew my dependent(s)' UHIP coverage. No, I need to add new dependent(s) under my UHIP.

You must add your new dependent within 30 days of arrival in Canada. There is a $500 late fee if your application is submitted greater than 30 days after arrival.

You must renew your dependent each year. Please ensure you apply to renew your dependent within thirty days of eligibility, or there is a $500 late fee applied by UHIP.
Name -- Dependent 1 Name -- Dependent 1 * First Last
Date of Birth - Dependent 1 Date of Birth - Dependent 1 * / MM / DD YYYY
Gender - Dependent 1 *

Gender - Dependent 1 Male Female
Relationship - Dependent 1 *

Relationship - Dependent 1 Spouse Child
Date of arrival in Canada - Dependent 1 Date of arrival in Canada - Dependent 1 * / MM / DD YYYY
Name -- Dependent 2 (if applicable) Name -- Dependent 2 (if applicable) First Last
Date of Birth - Dependent 2 (if applicable) Date of Birth - Dependent 2 (if applicable) / MM / DD YYYY
Gender - Dependent 2 (if applicable)

Gender - Dependent 2 (if applicable) Male Female
Relationship - Dependent 2 (if applicable)

Relationship - Dependent 2 (if applicable) Spouse Child
Date of arrival in Canada - Dependent 2 (if applicable) Date of arrival in Canada - Dependent 2 (if applicable) / MM / DD YYYY
Name -- Dependent 3 (if applicable) Name -- Dependent 3 (if applicable) First Last
Date of Birth - Dependent 3 (if applicable) Date of Birth - Dependent 3 (if applicable) / MM / DD YYYY
Gender - Dependent 3 (if applicable)

Gender - Dependent 3 (if applicable) Male Female
Relationship - Dependent 3 (if applicable)

Relationship - Dependent 3 (if applicable) Spouse Child
Date of arrival in Canada - Dependent 3 (if applicable) Date of arrival in Canada - Dependent 3 (if applicable) / MM / DD YYYY
Name -- Dependent 4 (if applicable) Name -- Dependent 4 (if applicable) First Last
Date of Birth - Dependent 4 (if applicable) Date of Birth - Dependent 4 (if applicable) / MM / DD YYYY
Gender - Dependent 4 (if applicable)

Gender - Dependent 4 (if applicable) Male Female
Relationship - Dependent 4 (if applicable)

Relationship - Dependent 4 (if applicable) Spouse Child
Date of arrival in Canada - Dependent 4 (if applicable) Date of arrival in Canada - Dependent 4 (if applicable) / MM / DD YYYY
Name -- Dependent 5 (if applicable) Name -- Dependent 5 (if applicable) First Last
Date of Birth - Dependent 5 (if applicable) Date of Birth - Dependent 5 (if applicable) / MM / DD YYYY
Gender - Dependent 5 (if applicable)

Gender - Dependent 5 (if applicable) Male Female
Relationship - Dependent 5 (if applicable)

Relationship - Dependent 5 (if applicable) Spouse Child
Date of arrival in Canada - Dependent 5 (if applicable) Date of arrival in Canada - Dependent 5 (if applicable) / MM / DD YYYY
Adding new dependent(s):

Please upload the following document(s) (pdf, jpeg, and png files accepted):

Your dependent’s work/study/visitor permit. If they do not have a permit, then please upload a copy of their passport page with the date of entry stamp and the front page of the passport.

NOTE: You must submit this form to add new or renew dependents within 30 days of their arrival or eligibility of coverage. Otherwise, there is a $500 late fee. *

Attach Files
Applying for UHIP as a Visiting Scholar/temporary interntional faculty

NOTE: If you are a post-doc/visiting scholar/temporary faculty who is being compensated by York University, your UHIP will most likely be processed by Pensions & Benefits. Please contact askpb@yorku.ca. If you are not being compensated, please complete this form.

Please upload the following documents (pdf, jpeg, and png files accepted):

1) Completed and signed UHIP application form. You can find the form here: https://uhip.ca/wp-content/uploads/2022/08/UHIP-Application-Form-aGL5725E-E_0722.pdf

2) Copy of your invitation letter,

3) Copy of your work permit,

Optional - only to be sent if you have dependent(s) (spouse and/or children) here with you:

4)Your dependent’s work/study/visitor permit. If they do not have a permit, then please upload a copy of their passport page with the date of entry stamp and the front page of the passport.

NOTE: You must submit this form to add new dependents within 30 days of their arrival. Otherwise, there is a $500 late fee. *

Attach Files
Applying to UHIP as an IVRT:

Please upload the following documents (pdf, jpeg, and png files accepted)

1) Completed and signed UHIP application form. You can find the form here: https://uhip.ca/wp-content/uploads/2022/08/UHIP-Application-Form-aGL5725E-E_0722.pdf

2) Copy of your invitation letter,

3) Copy of your York offer letter (which includes your student number),

3) Copy of your work permit,

Optional - only to be sent if you have dependent(s) (spouse and/or children) here with you:

4)Your dependent’s work/study/visitor permit. If they do not have a permit, then please upload a copy of their passport page with the date of entry stamp and the front page of the passport.

NOTE: You must submit this form to add new dependents within 30 days of their arrival. Otherwise, there is a $500 late fee. *

Attach Files
What is convocation month? *

What is convocation month? June October February

If your convocation month is February, you are most likely already enrolled under UHIP until August. In this case, you are eligible to be extend your UHIP coverage. You will need to look into private health plans.
Applying for UHIP extension after graduation:

Please upload the following documents (pdf, jpeg, and png files accepted):

1) Completed and signed UHIP application form. You can find the form here: https://uhip.ca/wp-content/uploads/2022/08/UHIP-Application-Form-aGL5725E-E_0722.pdf

Optional (if you only recently applied for graduation or have not applied for graduation yet)
2) Confirmation email or letter that you have completed your degree requirements. This is only needed if your record of graduation is not yet showing in the university records. *

Attach Files
What kind of leave of absence are you under? *

What kind of leave of absence are you under? Medical Non-medical Maternity/paternity
Which term are you taking off for your medical or non-medical leave of absence?

NOTE: you can only be enrolled under UHIP for up to 4 months. *

Which term are you taking off for your medical or non-medical leave of absence?

NOTE: you can only be enrolled under UHIP for up to 4 months. Fall 2021 Winter 2022 Summer 2022 Fall 2022 Winter 2023
Which term are you taking off your maternity/paternity leave of absence?

NOTE: you can only be enrolled under UHIP for up to 12 months. *

Which term are you taking off your maternity/paternity leave of absence?

NOTE: you can only be enrolled under UHIP for up to 12 months. Fall 2021 and returning in Fall 2022 Winter 2022 and returning in Winter 2023 Summer 2022 returning in Summer 2023 Other (please indicate which term and year you are taking off, and which term and year you will be returning to studies)
I confirm that I will return to studies in Winter 2023. *

I confirm that I will return to studies in Winter 2023. Confirm
I confirm that I will return to studies in Summer 2023. *

I confirm that I will return to studies in Summer 2023. Confirm
I confirm that I will return to studies in Fall 2022. *

I confirm that I will return to studies in Fall 2022. Confirm
Application form for UHIP application under a leave of absence:

Please upload a completed and signed UHIP application form (pdf, jpeg, and png files accepted).

You can find the application form here: https://uhip.ca/wp-content/uploads/2022/08/UHIP-Application-Form-aGL5725E-E_0722.pdf

For GRAD students: Your leave of absence (LOA) must be approved by the Faculty of Graduate Studies or your faculty to be eligible for UHIP. Please upload a copy of your LOA approval letter in addition to the application form. *

Attach Files