Coverage Information

General Plan Information

This insurance plan is exclusively contracted and provided for the international students and visiting scholars of Eastern Washington University. You can download the 2018-19 Student Health Insurance Brochure or contact Health, Wellness & Prevention Services at 509.359.4279 or stuhealth@ewu.edu or visit the University Recreation Center room 201 for more information.

Eligibility: F1/F2 and J1/J2 visa status with Eastern Washington University. Please note that dependents who are enrolled may be required to pay additional charges at the EWU Student Health Clinic for services. Please check with the EWU Student Health Clinic at MultiCare Rockwood in Cheney before requesting services for your dependents.

Summary of Benefits

Download the 2018-19 Summary of Benefits (PDF)

  • Co-pays are not required at the time of service.
  • After the $250 deductible is met, the student will be responsible for 20% of the cost of medical services (deductibles do not apply to doctor's office visit or prescriptions).
  • Annual physical exams are covered under wellness coverage with no deductible and no co-payment.
  • Immunizations are covered when ordered by a PVP and 80% of cost is covered in-network.
  • Contraceptives are covered under prescription drugs with no deductible and no co-payment.
  • Prescription drugs are covered at 80% if student goes to a preferred pharmacy in-network.
  • Emergency room is covered at 80% in-network/60% out of network.
  • Ambulance service is covered at 80% in-network/60% out of network.
  • X-ray & Laboratory services are covered at 80% in-network/60% out of network.
  • Hospital Room and Board is covered at 80% in-network/60% out of network.

Immunizations

Immunizations that meet Preventive Care Guidelines are payable with no cost share to the insured. Here are the instructions to locate and review the most current Preventive Care coverage determination guidelines.
 
Please note, this does not guarantee payment.  We are not able to determine if and what benefits are payable until an actual claim for services is received.  Benefit payment shall be subject to all deductible, copayment, coinsurance, exclusions and limitations, or any other provisions of the policy effective at the time of service.

Global Emergency Services

If you are a member insured with this insurance plan, you and your insured spouse Domestic Partner and minor child(ren) are eligible for UnitedHealthcare Global Emergency Services.

Key Services include:

  •  Transfer of Insurance Information to Medical Providers
  •  Monitoring of Treatment
  •  Transfer of Medical Records
  •  Medication, Vaccine
  •  Worldwide Medical and Dental Referrals
  •  Dispatch of Doctors/Specialists
  •  Emergency Medical Evacuation
  •  Facilitation of Hospital Admittance up to $5,000.00 payment
  •  Transportation to Join a Hospitalized Participant
  •  Transportation After Stabilization
  •  Coordinate the replacement of Corrective Lenses and Medical Devices
  •  Emergency Travel Arrangements
  •  Hotel Arrangements for Convalescence
  •  Continuous Updates to Family and Home Physician
  •  Return of Dependent Children
  •  Replacement of Lost or Stolen Travel Documents
  •  Repatriation of Mortal Remains
  •  Worldwide Destination Intelligence Destination Profiles
  •  Legal Referral
  •  Transfer of Funds
  •  Message Transmittals
  •  Translation Services
  •  Security and Political Evacuation Services
  •  Natural Disaster Evacuation Services

Please visit www.uhcsr.com/UHCGlobal for the UnitedHealthcare Global brochure which includes service descriptions and program exclusions and limitations.

Optional Dental and Vision Plans

Individual dental and vision plans are optional. View the Voluntary Dental & Vision Individual Plans document to find out more about your options as an EWU student/scholar. To enroll in one of these plans, contact the provider directly.

Providers

The MultiCare Rockwood Clinic in Cheney, WA is a preferred provider of non-emergency medical services. Click this link to find an in-network clinic, hospital, or other service near you.

EWU Student/Scholar ID and the insurance card is required at the time of service. Please note that dependents who are enrolled may be required to pay additional charges at the EWU Student Health Clinic for services. Please check with the EWU Student Health Clinic at MultiCare Rockwood in Cheney before requesting services for your dependents. Please note that the clinic may not have the language interpretation assistance so plan accordingly.

Further Information

If students/scholars receive any forms from A-G Administrators, the benefits administrator for the plan, they must complete those forms and mail them back immediately. Failure to follow up can cause claims to go unpaid, and Rockwood could then put students/scholars on a collections list.

For more information, visit Eastern's Health and Wellness site.