The Maksin Group | WSU Student Plan

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When can I enroll in the Student Medical Insurance Plan?

If I have an existing condition prior to the effective date of the Student Medical Insurance Plan, will the condition be covered?

What do I do to keep my continuous coverage so that my existing conditions are not considered pre-existing?

How and when can I cancel my Student Medical Insurance Plan?

I will be an exchange student to a different country. Will the Student Medical Insurance Plan cover me?

When will my coverage begin?

Is birth control covered?

Is there any coverage for allergy medications?

Are outpatient (not treated in the hospital) Mental Disorders covered under the Student Medical Insurance Plan?

Is pregnancy covered?

Is a newborn covered?

May I purchase the Student Medical Insurance Plan if I am not a student?

If I am involved in an intercollegiate sport sponsored by the Intercollegiate Athletic Department of the University will my injuries be covered?

Is there vision coverage?

Is there a death benefit to the Student Medical Insurance Plan?

Is there a PPO (Participating Provider Organization) network?

Where may I obtain a claim form?

Is there a Deductible for the Student Medical Insurance Plan?

When can I enroll in the Student Medical Insurance Plan?

Enrollment for the Student Medical Insurance Plan can be done during registration on-line. If you want to enroll later, the enrollment deadline for Fall and Spring coverage is the 10th day of classes. You may enroll at Health and Wellness Services, located in the Washington Building Room #120E or call the Student Insurance Coordinator at (509) 335- 3575. You may download an enrollment form at www.hws.wsu.edu/default.asp?PageID=2579.

If I have an existing condition prior to the effective date of the Student Medical Insurance Plan, 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.

A Covered Person whose coverage under prior Creditable Coverage ended no more than 63 days before the Covered Person's effective date under the Policy, will have any applicable Pre-Existing Condition Limitation reduced by the total number of days the Covered Person was covered by such coverage. If there was a break in Creditable Coverage of more than 63 days, the Company will credit only the days of such coverage after the break. See "Pre-Existing Condition Limitation" in the Plan Brochure for details.

What do I do to keep my continuous coverage so that my existing conditions are not considered pre-existing?

To keep continuous coverage once you have purchased the Student Medical Insurance Plan, you need to re-enroll prior to the start of the upcoming semester. Obtain enrollment information online at www.hws.wsu.edu/default.asp?PageID=2579 or (509) 335-3575. Graduate Students may contact Health and Wellness Services regarding continuation coverage, on a self-pay basis, after separation from Washington State University.

How and when can I cancel my Student Medical Insurance Plan?

You can cancel your Student Medical Insurance Plan by calling or visiting Health and Wellness Services. You may download a cancellation form at:

www.hws.wsu.edu/Content/Documents/hws/student%20insurance/fall%202009%20cancelation.pdf

The cancellation deadline for Annual, Fall and Spring/Summer semesters is the 10th day of classes. You will be enrolled in the plan and required to pay the premium if your cancellation is not requested by this deadline.

I will be an exchange student to a different country. Will the Student Medical Insurance Plan cover me?

Yes, the Student Medical Insurance Plan provides worldwide coverage.

When will my coverage begin?

Your coverage will begin on August 16, 2009 if you sign up for the coverage prior to this date. If you sign up for coverage after this date, then your coverage will begin the day after your sign-up date. See "Coverage Dates" section of Plan Brochure for details.

Is birth control covered?

Yes, prescription birth control pills and prescription birth control devices (e.g. IUDs) are covered.

Is there any coverage for allergy medications?

The Student Medical Insurance Plan will pay for allergy medication up to a maximum per the policy year of $300.00.

Are outpatient (not treated in the hospital) Mental Disorders covered under the Student Medical Insurance Plan?

Outpatient and Inpatient Mental or Nervous Disorder Expenses (combined) is paid as any other Sickness up to $3,000 maximum payment per Policy Year. Outpatient prescription drugs will be paid at 80% Generic / 60% Brand. See the Schedule of Benefits in Plan Brochure. For Dependents' benefits, see the Schedule of Benefits in the Plan Brochure.

Is pregnancy covered?

Yes, pregnancy is covered the same as any other sickness. Please see the Schedule of Benefits in the Plan Brochure.

Is a newborn covered?

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.

Well-Care for Children-Payment will be made at 90% of outpatient charges for routine physical examinations and scheduled immunizations, incurred from birth through age 7, when ordered by the attending Doctor. The maximum payment is $300 per Policy Year for each child. The Policy Year deductible is waived.

May I purchase the Student Medical Insurance Plan if I am not a student?

If you are not a WSU student or a spouse or domestic partner, or Dependent of a covered WSU student, you may not enroll in the Student Medical Insurance Plan. However, if you are a domestic student in the Fall and purchase Annual coverage, then you do not have to be a student in the Spring/Summer semester to continue the Student Medical Insurance Plan. A student must remain registered for classes for two weeks to remain eligible for the Student Medical Insurance Plan. See "Eligibility" section of Plan Brochure.

If I am involved in an intercollegiate sport sponsored by the Intercollegiate Athletic Department of the University will my injuries be covered?

No, intercollegiate sports are not covered on the Student Medical Insurance Plan. Intramural sports and other injuries are covered, subject to the policy provisions.

Is there vision coverage?

Yes. Please see the Schedule of Benefits in the Plan Brochure.

Is there a death benefit to the Student Medical Insurance 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/WsuStudent.aspx.

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/WsuStudent.aspx.

Is there a Deductible for the Student Medical Insurance Plan?

Yes, the Student Medical Insurance Plan has a $50 HWS Deductible and a $250 Deductible for Other Providers per Policy Year. After a student incurs $50 of HWS covered charges (may include RX) HWS benefits are payable. For providers outside of HWS, the deductible is $250, however any part of the deductible incurred at HWS may be used to offset a like amount of the $250 deductible.