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Northwestern University ̱бNorthwestern University
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.

 

 

 

insurance waiver?

 

̹ б ٸ ִ κ б쯕 ˷ մϴ

׷߸ б 迡 ʽϴ.
̰ б쯕 䱸 ϴ Ŀ Ȯ Է ϼž մϴ

2010 Ի б ݵ Ͽ߸ մϴ ׷ ùα ߱

Ի̶ ϽǼ ֽϴ

 

 

 

Ʒǥ ǥԴϴ.

 

 

 

 

Insurance  Provider

 

б





DBغ





 

 

Major Benefit

 

 

$500,000

$75,000 per Sickness or Injury

 

 

Life Maximum

 

 

$500,000

Unlimited

Copayment

 

ȸ

 

In Network          (º): 80%

 

Out of Network (º): 70%

 

100%

 

Deductible

 

δ

 

$250

No deductible

 

Dental Injury

Expenses

 

 

 

Covered Medical Expenses are payable at 80% of the Actual Charge up to $200 per tooth for the treatment of an Injury to sound, natural teeth

 

ʴ¼ظ Ѻκп ()

(ö .ö ġƱ. )

 

Out-of-Pocket Maximum

 

Ⱓδ

 

$1,000

$0

Prescription Drug

 

ప /δ

 

In Network: Covered Medical Expenses are payable at 100% of the Negotiated Charge after a $10 Copay for Generic Prescription Drugs, and 100% after a $25 Copay for Brand Name Prescription Drugs.

 

100 %

 

Out of Network: 50% of the Reasonable Charge after a $10 Deductible for Generic Prescription Drugs, and 50% after a $25 Deductible for Brand Name Prescription Drugs

 

100%

Premium

(Annual)

 

Student:$2,584

Spouse:$4,720

Child(ren):$2,952

 

Student:$480

Spouse:$480

Child(ren):$480

 


 

 

 

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