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Indiana University
Visiting Scholar 
Insurance Plan

Visiting Scholar Custom Enrollment Form
2026-2027 Academic Year

Enter the 2026-2027 visiting scholar enrollment code below. The international office on your campus can give you the enrollment code and permission to access the enrollment form.  

This form is for coverage effective 08/01/2026. For coverage effective before 08/01/2026, click HERE to access the 2025-2026 visiting scholar enrollment form. 

OPT students cannot use this form and must use the OPT Semester or Qualifying Event Enrollment Form 

Asterisk (*) denotes required field

SCHOLAR / STUDENT INFORMATION

 (MM/DD/YYYY)