Midwestern State University |
̱бMidwestern State University |
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Ȩ л, ȯ, ýĮ, Ʈ, ⱹϽô ݰ е ϽǼ ִ Դϴ. Ͻø û ۼ ֽðų ̸ ֽø ˴ϴ. ǽð Ͻø MSN ȭ ߰ ֽø ܱ ô Ǹ ϽǼ ֽϴ. |
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Student Insurance Up to $50,000 Lifetime Maximum Benefit Paid as specified below for each Covered Injury or Sickness Deductible $100 Per Covered Person (Per Policy Year)
IMPORTANT VINSON HEALTH CENTER INFORMATION (VHC) (Student Only): The plan deductible will be waived and Covered Expenses will be paid at 100% at the VHC. Benefits provided at the VHC are: One annual PAP Smear will be covered up to $30 maximum benefit. Annual Well Woman Exam will be covered up to $150 maximum when referred by the VHC. Benefits will be paid at 80% of the Preferred Provider Allowance for services rendered by Preferred Providers in the Beech Street, Inc. Network unless otherwise specified below. Services obtained by Out-of-Network providers (any provider outside the Beech Street, Inc. Network) will be paid at 60% of Usual & Customary Charges unless otherwise specified below. Benefits will be paid up to the maximum amount shown below regardless of the provider selected not to exceed the Medical Expense Lifetime Maximum Benefit of $50,000. Unless otherwise specified, the maximum amounts apply on a per covered Injury or Sickness basis. Covered Expenses are:
Annual |
08-23-2008 to 08-23-2009 |
Fall Semester |
08-23-2008 to 01-10-2009 |
Spring |
01-10-2009 to 05-23-2009 |
Spring/Summer Semester |
01-10-2009 to 08-23-2009 |
Summer Semester |
05-23-2009 to 08-23-2009 | | |
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http://students.mwsu.edu/international/insurancewaiverform2007.htm
* б 㺸 https://www.academichealthplans.com/mwsu/2008-2009/brochure.php
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б | | DBغ |
$200,000 Lifetime Maximum Benefit |
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ѵ $100,000 / $50,000 ѵ ( ) |
$100 Deductible (/ ) |
Deductible δ |
$0 Deductible
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When purchasing a prescription at the Trott's Call Field Drug Store, you will pay a $10 copay for generic prescriptions and a $20 copay for brand name prescriptions after the $50 prescription deductible has been satisfied. The deductible is not subject to the $100 plan deductible. Participating Pharmacies Only Expenses are payable at a 50% copayment at a participating WellDyneRx pharmacy. Benefits will not exceed the $300 maximum per policy |
Oupatient Prescription Drug Benefit ప copay ( δ) |
ȸ翡 100% (ó) |
In Network 80% /
Out of Network 660% º/ |
翡
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Out-of-Network/ Out of Network 100% |
Annual: 08/23/08 to 08/23/09 Student : $620 Spouse: $2,065 Child: $850 |
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л $480 $480 ڳ $480 | |
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