To be eligible for continuation Coverage, you must have been insured for at least 3 continuous months on the Purdue Student Health Insurance Plan, and you must submit premium within 30 days after your existing coverage terminates.

If you believe you are eligible for Continuation Coverage, please download the form below and follow the instructions to apply.

Sending the form in by fax to (855) 858-1964 is the preferred method. If you cannot fax the form in, you can email it to purdue@ahpservice.com without filling in your payment information and one of our representatives will contact you to complete payment. Please be sure to include the telephone number where you can be reached.

Use Anthem's online Find a Doctor tool to look for doctors, dentists, hospitals, labs, and other health care providers in your Anthem Blue Cross and Blue Shield plan. Check if the provider you intend to see is part of your plan (in network), or look for one near you. Avoid getting care from doctors outside of your plan (out of network) if you can - it will cost you more or your plan may not cover it all.

With an appropriate qualifying life event (QLE) and supporting documentation, you may make certain changes to your plan, including:

• Add/Enroll
  • QLE: Involuntary loss of coverage (e.g. aging off of a parent's plan)

• Drop
  • QLE: Gaining coverage under another plan, leaving the US

• Add Dependents
  • QLE: Marriage, birth or adoption, arrival of family members to the US

• Drop Dependents
  • QLE: Divorce, death, departure of family members to the US

Required documentation includes proof of event and proof of dependent relationship.  Examples: Proof of loss/gain of coverage, proof of arrival/departure of family members to the US, marriage certificate or divorce decree, birth/naturalization/adoption certificate, tax return for prior or current year (verifies dependent relationship to student).

Changes to the graduate staff voluntary benefits, including dental insurance with Delta Dental, must be done through the Benefitfocus portal. Visit the Graduate Staff Benefits QLE website for more information.

It is very important to make sure that your address, phone number, and email address on file at Purdue University are current and accurate. If not, ID cards, explanation of benefits, and other notifications about your student health insurance plan may not get to you. If you have moved or your contact information has changed, please make sure you update your contact information with Purdue University. To update your contact information, please refer to the instructions in the bottom-left corner of the “Managing Your Employee Profile Cheat Sheet”.  Contact our Human Resources Customer Service at (765) 494-2222 or hr@purdue.edu if you need assistance with this process.

Additionally, please notify us at support@ahpcare.com so we can update our records as well. Please include “Contact information update” in the subject line and your first name, last name, and student ID, as well your new contact information, in the email message.