2009-2010
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 |
9/17/09 to 9/17/10 |
| 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 |
$1,500 per benefit year |
| Co-Pays-Generic |
$10 |
| Brand Name |
$20 |
| Non-Formulary |
$20 |
| 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 |
|
2009-10
Rates |
Annual
9-17-09 to
9-16-10 |
Fall
9-17-09 to
1-3-10 |
Winter
1-4-10 to
3-29-10 |
Spring
3-30-10 to
6-21-10 |
Spring/Summer
3-30-10 to
9-16-10 |
Summer
6-23-10 to
9-16-10 |
| Student |
$1,489 |
$456 |
$346 |
$338 |
$683 |
$338 |
| Spouse |
$3,626 |
$1,113 |
$844 |
$825 |
$1,669 |
$825 |
| Child |
$2,268 |
$696 |
$528 |
$516 |
$1,044 |
$516 |
| Children (2+) |
$2,268 |
$696 |
$528 |
$516 |
$1,044 |
$516 |
|
| Age Rated? |
Rates Same for All ages |
