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Student Health Plans

Eastern Washington University
2008-2009
EASTERN WASHINGTON UNIVERSITY
STUDENT HEALTH INSURANCE PLAN
This optional insurance plan is exclusively contracted and provided for the students of Eastern Washington University. On campus, please contact Health, Wellness & Prevention Services, 509-359-4279 or visit University Recreation Center 201 for more detailed information.
Offered by: Aetna Life Insurance Company
Coverage Acceptance Guaranteed
Policy Period 9/17/08 to 9/17/09
Eligibility Minimum 6 credit hours Fall, Winter & Spring – Minimum 3 credits in Summer
MEDICAL
Maximum Benefit/Period $75,000 per condition
Deductible/Period $150 per benefit year
ADDITIONAL CO-PAYS
Emergency Room $100 - waived if admitted
Doctor Visits $20 CoPay within Network
Prescription Maximum $2,000 per benefit year
Co-Pays-Generic $10
Brand Name $10
Non-Formulary $10
COINSURANCE - COMPANY PAYS
In-Network 80%
Out of Network 50%
Maximum Out of Pocket $3,150 per benefit year
Hospital In Patient 80% in Network
Professional Services 80% in Network
Preventive Care Covered expenses include an annual Pap screening for women ages 18 & older and one baseline mammogram for women between ages of 35 & 40. Women 40 & older have coverage for an annual mammogram per policy year, subject to Co-Pays.
PREMIUMS  
2008-09
Rates
Annual
9-17-08 to
9-16-09
Fall
9-17-08 to
1-6-09
Winter
1-7-09 to
4-1-09
Spring
4-2-09 to
6-23-09
Spring/Summer
4-2-09 to
9-6-09
Summer
6-24-09 to
9-16-09
Student $1,324 $406 $308 $302 $610 $308
Spouse $3,234 $993 $754 $733 $1,487 $754
Child $2,023 $621 $471 $460 $931 $471
Children (2+) $2,023 $621 $471 $460 $931 $471
Age Rated? Rates Same for All ages

This is not a coverage certificate. For a full description or brochure from the web site at www.fidelityins.com.

If you have questions, please call Fidelity at 509-462-7862 or 1-800-223-7954 and ask for Alan Wolfson.

To Apply for Aetna Coverage

CLICK HERE or on the logo below to apply for Aetna coverage.

Aetna Life

Alternative Plans

CLICK HERE for optional plans through Asuris northwest Health and LifeWise Health Plan of Washington.

Definitions
Deductible A deductible is an amount payable by the subscriber for health care before certain contractual benefits are available. Some benefits may be payable without a deductible.
Coinsurance Student percentage of cost share after the deductible has been met
Maximum Out-of-Pocket This is the maximum amount a student will pay per contract before the policy will pay 100% thereafter for covered services received. Copays do not apply