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Maksin Group // Maksin Services // College Students // Washington State University // WSU Graduate Student Assistant Plan // FAQ
Is the Deductible amount incurred for the calendar year beginning in January? No. The Deductible amount is incurred for the Policy Year (August 16, 2011 ending at 12:01 a.m., August 16, 2012). If I want to get a routine physical, will the insurance cover it? The insurance covers treatment of sickness and injury; however, the insurance Policy offers a "Wellness Benefit" which includes routine Doctor's office visits, physical examinations and laboratory tests, per the Payment Schedule up to a $150 Policy Year maximum and is not subject to the Deductible. Please see the Schedule of Benefits in the Plan Brochure. What makes me eligible for the GSA Insurance?
Yes, prescription birth control pills and prescription birth control devices (e.g. IUDs) are covered. Is there any coverage for allergy medications? The student insurance policy will pay for allergy medication up to a maximum per the policy year of $300.00. See the Schedule of Benefits in the Plan Brochure. Are outpatient (not treated in the hospital) Mental Disorders covered under the Student Medical Insurance Plan? Outpatient and Inpatient Mental or Nervous Disorder Expense is paid as any other Sickness. Outpatient prescription drugs will be paid at 80% Generic / 60% Brand. See the Schedule of Benefits in the Plan Brochure. For Dependents' benefits, see the Schedule of Benefits in the Plan Brochure. Yes, pregnancy is covered the same as any other sickness. Please see the Schedule of Benefits in the Plan Brochure. A child born to an Insured Student is automatically covered from the moment of birth until such child is 31 days old. Coverage for such child will be for Sickness and Injury, including medically diagnosed congenital defects, birth abnormalities, prematurity and nursery care. However, the Insured Student must enroll the child within 31 days of such birth and pay the required additional premium in order to have coverage for the newborn child continue beyond such 31 day period. If you choose to enroll your newborn child, please visit Health and Wellness Services within 31 days of such birth to obtain an enrollment form. Is there a death benefit to the plan? Yes, the benefit for accidental loss of life is $10,000. Is there a PPO (Participating Provider Organization) network? Yes. Covered Persons may choose to be treated within or outside of the Beech Street PPO Network. This network consists of hospitals, doctors and other health care providers organized into a network for the purpose of delivering quality health care at affordable rates. Therefore, when a Covered Person uses a Beech Street Participating Provider, his or her fee may be reduced. A complete listing of providers is available on the Beech Street website link accessible at: www.maksin.com/WsuGrad.aspx. Is there a preferred provider listing for (students only) vision care? Yes. If a Beech Street participating provider is used, the Covered Student's fee may be reduced. You may access the Beech Street PPO website at: www.maksin.com/wsu.aspx. If I have an existing condition prior to the effective date of the GSA Insurance, will the condition be covered? There is no coverage for Pre-existing Conditions during the first 3 months following a Covered Person's effective date of coverage under the Policy. This limitation will not apply if, during the period immediately preceding the Covered Person's effective date of coverage under the Policy, the Covered Person was covered under prior Creditable Coverage for 3 consecutive months. Prior Creditable Coverage of less than 3 months will be credited toward satisfying the Pre-existing Condition Limitation. The Covered Person must provide proof of Creditable Coverage.
May I continue my coverage on a self-pay basis after my Graduate Appointment ends? Yes. Please contact Health and Wellness Services regarding continuation coverage, on a self-pay basis, after your Graduate Appointment ends. Where may I obtain a claim form? You may submit claims electronically via the online claim form or download a claim form. The online claim form and claim form PDF are both accessible at www.maksin.com/WsuGrad.aspx. Is my Dental Policy carried by National Union Fire Insurance Company of Pittsburgh, Pa.? No. The Dental Policy is carried by a different insurance carrier. For details go to: http://www.hws.wsu.edu/default.asp?PageID=2582. Is there a Deductible for the GSA Insurance Plan? Yes, the GSA Insurance Plan has a $50 HWS Deductible and $100 Deductible for Other Providers per Policy Year. Prescriptions are payable only after $100 of Eligible Expenses are applied to the Deductible no matter where the Eligible Expenses are incurred. |
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