Medical & Dental Benefits Coverage
For more information about Graduate Student Health Insurance coverages, billing, claims, etc. please visit WSU Health & Wellness Services Website.
COVERAGE DATES
Covered Graduate Student Assistants and Graduate Research Fellows/Trainees will be insured during these Policy Periods:
- Fall - Coverage begins at 12:01 a.m. August 16, 2008 and ends at 12:01 a.m., January 1, 2009
- Spring/Summer - Coverage begins at 12:01 a.m. January 1, 2009 and ends at 12:01 a.m., August 16, 2009
If the Covered Person is Hospital Confined on the effective date of coverage under the Policy, coverage is not effective until the individual is discharged from the Hospital.
Vision Care
- One eye exam in 24 month period
- Lenses, frames and/or contact lenses
- There are NO benefits for dependents
Visiting the Doctor
- Health and Wellness Services (HWS - Pullman Campus only)
- 100% of Allowable Charges
- Dependents also receive 100% of Allowable Charges
- Any other provider
- 80% of Reasonable and Customary Charges
- No benefits for dependents with outside providers.
- Prescription Drugs
- For students: 80% brand name/60% generic
- For dependents: 80% brand name/50% generic
Dental Care
- For students only
- Policy year deductable = $50 per person
- Covered (Class I) treatments (90% reimbursement) include:
Treatment | Policy Year Coverage |
Routine Examinations | 1 exam per policy year |
Comprehensive Oral Exam | 1 exam per 3 year period |
X-Rays | Once per 36 month period |
Preventive Cleaning | Twice per policy year |
*Plaque control programs, sealants, and topical fluoride treatments are EXCLUDED from coverage
- Covered (Class II) treatments (75% reimbursement) include: General anesthesia, intravenous sedation, palliative treatment, restorative treatment (amalgam restorations, dental decay , crowns, etc), oral surgery, periodontal treatment (gums and tissue), endodontic (root canal).
- Dental Insurance EXCLUDES bleaching or cosmetic treatments.
Visit the Medical Health Plan Summary for a more complete list of coverages.
HOW TO FILE A MEDICAL/VISION CLAIM
Obtain a Graduate Student Assistant Medical Insurance claim form from Health and Wellness Services, Washington Bldg., phone (509) 335-8216. Or access the Maksin Health Insurance website:
FOR INITIAL CLAIM, EACH CONDITION
- Complete front and back side of claim form.
- Attach the Doctor's bill.
- Send Claim form and all itemized bills to:
Maksin Management Corp
P.O. Box 2677
Camden, NJ 08101-2677
1-877-775-5430
TO SUBMIT SUBSEQUENT EXPENSES, SAME CONDITION
Once you have filed the initial claim:
- Complete the front of the claim form.
- Obtain itemized Doctor's bill(s).
- Mark the claim form "Continuing Claim.''
- Send claim form and additional itemized bills to the above address.
For additional questions on health coverage please visit the Maskin FAQ webpage
