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Student Health Insurance

Student Health Insurance is mandatory for all Western Illinois University students who are taking 9 semester hours or more or more of on-campus classes*. The Student Health Insurance should be used along with existing family coverage, and student insurance is suggested as way to provide the student with guaranteed coverage, 24 hours a day protection and a very low deductible in the event of accident or illness. WIU’s Student Insurance will provide help for mental health and substance abuse issues, as well as hospital stays, maternity care and ambulance transport.

The Student Health Insurance office is located in the Lower Level of Beu Health Center. Call (309) 298-1882 for more information. Hearing Impaired Students call TTY: (309) 298-1856.

2010-2011 Student Health Insurance Benefits

Benefits at a Glance
Schedule of Benefits

Coverage Benefit
Lifetime Maximum Benefits $250,000
The deductible must be paid before the benefits can be utilized.
This does not apply to Beu Health Center. 		$200 per policy year
Medical Emergency
Must obtain care within 48 hours 		80% of UCR
Emergency Room Visit – Referred by Beu Health Center or Out-of-Area 80% of UCR
Hospital Room and Board 80% of UCR
Hospital Miscellaneous Benefit 80% of UCR
Surgical Benefit 80% of UCR
Assistant Surgeon Benefit 50% of UCR
Anesthetist Benefit 80% of UCR
Doctor’s Visits – Inpatient and Outpatient 80% of UCR
Outpatient Diagnostic X-Ray and Laboratory Test Expense 80% of UCR
Accidental Dental Benefit Injury to Sound Natural Teeth 80% of UCR
maximum $500 per tooth
Chiropractic Benefit 80% of UCR
$30 per visit up to a maximum of
$500 per policy year
Consultant Benefit 80% of UCR
Mental Nervous Benefit***
Inpatient
Outpatient 		80% of UCR
50% of UCR, $2,000 max per policy year/1 visit per week
Alcohol and Substance Abuse Benefit***
Inpatient**
Outpatient 		80% of UCR
50% of UCR, one visit per week:
$30 max per visit;
$2,000 max per policy year
Ambulance Benefit 80% of UCR
Maternity Benefit 80% of UCR
Physiotherapy Benefit 80% of UCR past surgical
or referral from Beu Health Center
$500 maximum per policy year
Beu Health Center no deductible applied
100% of approved charges

**Referral from Campus Health Center is required.
***Combined Lifetime maximum for mental illness and alcohol, and substance abuse is $20,000.
Note: Student must be insured at the time medical expense in incurred for benefits listed above to apply. Any other insurance coverage is used in determining the amount of benefit payable under this Plan.

Other insurance coverage is used in determining the amount of benefits payable under this Policy.
Note: Student MUST be insured at the time medical expense is incurred.
Note: The Student Health Insurance Plan or costs associated with the plan may change periodically. Please check with Student Insurance for current plan and rates.

Coverage Period

The plan protects all eligible students 24 hours a day. Continuous year-round coverage is available if the student maintains 9 semester hours, undergraduate or graduate, during the fall and spring semesters.

Student Eligibility

All students who are registered for 9 undergraduate or graduate semester hours during the Fall and Spring Terms* will be eligible for coverage under this Plan. All graduate assistants under contract with the University and enrolled in on-campus classes, WESL students and Spoon River College students residing in University housing are also assessed the fee for this coverage. All students eligible for coverage under this Plan will be assessed a Student Health Insurance fee on their University bill.
*excluding post session, extension, correspondence, extramural or on-line hours

The following students can also sign-up for coverage by contacting the Student Health Insurance Office:

  1. Extension, on-line and WIU-QC students who register for 9, 10 or 11 hours. Application to be made during the first ten days of the term. Application must be made each semester coverage is desired.
  2. Undergraduate and graduate students who require less than 9 hours to graduate, have graduate clearance forms on file, and are registered for 6, 7 or 8 hours. Applications are to be made during the first ten days of the term.
  3. Insured graduating students who will not be enrolled in classes during the term following graduation. Application to be made prior to the last day of the covered period. Coverage for these students is available for 3 months.

Effective Dates

  • Fall Semester: 08/01/10 (12:01 a.m.) to 1/31/11 (midnight)
  • Spring Semester: 02/01/11 (12:01 a.m.) to 07/31/11 (midnight)

Costs

  • Student per Semester: $329.64
  • Graduating Students: $164.82 (3 months coverage)

2011-2012 Insurance Rate Information

  • Student per Semester: $369.19
  • Graduating Students: $184.60 (3 months coverage)

Claim Procedures

In the event of an injury or illness, an insured student MUST:

  1. If on campus or residing locally, report to Beu Health Center for proper medical treatment or referral.
  2. For outpatient treatment of mental illness or substance abuse, contact the Director of the Counseling Center and/or Director of Beu Health Center to determine if a professional non-University referral is necessary.
  3. If away from the University, a) consult a Physician; b) contact the Student Health Insurance office for claim forms.
  4. An insurance claim form along with itemized bills with diagnosis must be submitted to the Student Health Insurance Office within 52 weeks from the date of medical expense to be eligible for benefits.

Waiver of Coverage

The deadline for filing an Insurance Waiver Form is the 10th class day of the Fall and Spring Terms. The waiver cancels insurance coverage for all terms for which the student enrolls as long as the student is enrolled at least one term each academic year. Student insurance can be reinstated by contacting the Student Health Insurance Office prior to the 10th class day, or within 30 days of private policy termination. A reinstatement form must be completed and returned with documentation of termination from private policy.

Step 1 - Determine if your plan qualifies to waive

Your insurance plan must meet several requirements in order to waive the Student Health Benefits Plan. If you plan does not meet these requirements, you will be enrolled in the Student Health Benefits Plan.

Comparable Coverage means that your health plan meets ALL of the following waiver criteria:

  • The annual deductible must be no more than $300 per Plan Year; and
  • There is no less than a $250,000 lifetime plan maximum benefit, with no per illness/injury maximum less than $250,000; and
  • Must provide proof of coverage including copy of insurance card and schedule of benefits showing policy deductible and policy maximum; and
  • Coverage must be in effect during entire semester as follows:
    • Fall Semester 2009: August 1, 2009 - January 31, 2010
    • Spring Semester 2010: February 1, 2010 - July 31, 2010

In addition, International student’s insurance plan benefits must include:

  • Minimum of $10,000 in medical evacuation; $7500 in repatriation benefits; and
  • A company licensed to do business in the United States with (a) a U.S. claim payment office, (b) a U.S. telephone number, and (c) plan literature in English.

NOTE: Travel plans that cover emergency medical benefits only do not meet the waiver criteria.

Step 2 - Obtain a copy of your plan's schedule of benefits

This documentation should be printed in a policy brochure or can be requested from your insurance company. The schedule of benefits must show that your plan meets the requirements to waive the Student Health Insurance Plan listed in Step 1.

Step 3 - Complete and submit the waiver form

Waiver forms are available in the Student Insurance Office, or may be downloaded here.

  • The form must be filled out completely including student ID (not SSN).
  • Attach a copy of the front and back of your insurance card and the summary of benefits.
  • Bring the waiver form to the Student Insurance Office or mail/fax to:

    Student Health Benefits Office
    Western Illinois University
    1 University Circle
    Macomb, IL 61455
    Fax: (309) 298-2363

Student Health Insurance

Western Illinois University's Student Accident and Illness Insurance Plan is intended to supplement and complement services normally available to students through Beu Health Center. Services of the Health Center are available to all students. Even if you are not covered by Student Insurance, you may still use the Health Center at no additional charge. The Student Health Insurance Office is located in the lower level of Beu Health Center.

Questions?

Phone: (309) 298-1882
TT#: (309) 298-1856(for hearing impaired)
FAX: (309) 298-2363

Insurance Topics

Contact Info

Beu Health Center
1 University Circle
Macomb, IL 61455

Phone: (309) 298-1888
Fax: (309) 298-2188
E-mail: MM-Harris@wiu.edu