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.

Domestic Students: Use the "Find a Dentist" link if you are looking for pediatric dental services or for accidental dental injuries.

International Students: Use the "Find a Dentist" link if you are looking for pediatric dental services or for adult dental services with your dental insurance.

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.

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.