Ȩ Ұ ̱б ⺸谡Խû ܱ⺸谡Խû û
 
 
 
 
 



home ⺸ Խû
 
University of Washington ̱бUniversity of Washington
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.

 

 

  

 

J Exchange Visitor Insurance Require


100,000 per accident or illness.


$25,000 for repatriation of remains.


$50,000 for medical evacuation to the home country.


A "deductible" not to exceed $500.


Please see your international advisor for further details

 

 

 

 

 

 

  University Of Washington ǥԴϴ

 

 

 

Insurance  Provider

 

б

SHIP÷

DBغ

 

Lifetime Maximum

 

 

              $200,000

Unlimited

 

 

Benefit

 

 

$200,000 

 

 

$100,000 per Sickness or Injury

 

 

Deductible

 

δ

 

$75 per quarter per insured person up to a maximum deductible of $300 per policy year

 

$0

 

º̿/ȸδ

 

 

 

Network providers:

 

the plan pays 80% after you pay a $300 copay per admission; you pay the other 20%

 

100%

 

º/ȸδ

 

 

Out-of-Network

Provider:

 

the plan pays 60% after you pay a $400 copay • per admission; you pay the other 40%

 

100%

 

 

Prescription Drug

 

(పδ)

 

 

Rubenstein Pharmacy

(on campus at Hall Health)

 

You pay the higher of:

 

Generic: 20% or $15 copay

Brand formulary: 30% or $25 copayNon-formulary: 40% or $30 copayMaximum copay/coinsurance of up to $200/prescription

 

.

 

ѵ

δ

 

UMC/UWP pharmacies

 

You pay the higher of:

 

Generic: 30% or $15copay

Brand formulary: 40% or $25 copayNon-formulary: 50% or $30 copayMaximum copay/coinsurance of up to $200/prescription

 

Out-of-network pharmacies

 

You pay:

 

Generic: 50%

Brand formulary: 50%

Non-formulary: 50%

Maximum copay/coinsurance of up to $200/prescription

 

 

Premium

(Annual)

 

 

Student: $1,840

Spouse: $2,744

Child(ren): $2,320

 

Student: $480

Spouse: $480

Child: $480



 

 

 

 

 

ʴ


   1. (谡 ִ ȯ̳ ü ġ ˻縦 ߻
   2. ӽ, õ
   3. ܼ ǰ ˻縦 ϴ (÷ ˻ ǰ
   4 . (б н Immunization

5. Ű ȯ/ൿ

6. HIV()

7. 񴢱(ΰἮ)

8. 񴢱 ȯN39 Ǵ DZ