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Washington University in St. Louis ̱бWashington University in St. Louis
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.

 

 

 

 

  Washington University in St. Louis   Ͽϴ.

 

 

 

Insurance  Provider

 

б޺

Alternative Medical Plan

 

DBغ

 

 

Life Maximum

 

 

$500,000

Unlimited

 

 

benefits

 

 

$500,000

$50,000 per Sickness or Injury

 

 

Deductible

 

δ

 

 

 

 

Preferred Care:

 

$250 per Covered Person, per Policy Year 

 

 

$0

 

Non-Preferred Care:

 

$500 per Covered Person, per Policy Year 

 

                           $0

Preferred Care:

 

º̿

ȸ纸

 

80%

100% ȸ翡

 

Non-Preferred Care:

 

º̿

ȸ纸

 

50%

100% ȸ翡

 

 

Out-of-Pocket Maximum

 

Ⱓ δ

 

 

 

$5,000 per Covered Person, per Policy Year

$0

 

 

 

 

Prescription Drug

 

δ

 

౹̿:

 

Ϲ ó ó Copay : $ 20 ü ó 10 % δ

 

̸ ó ó Copay : $ 40 ü ó 50 % δ

 

δ

Premium

(Annual)

 

 Student:$617

Spouse:$1667

Child:$1,004

 

Student:$480

Spouse:$480

Child:$480

 



 

 

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