Who is eligible?
The Student Health Service is a mandatory self-funded program of services available to full-time students enrolled in the medical or allied professional schools of Washington University in St. Louis School of Medicine (WUSM). All WUSM full-time, medical students are automatically charged for the health fee and enrolled in the Student Health Service. There is no waiver for this fee based on existing health insurance coverage.
Participation in the Washington University School of Medicine Student Health Service is required for all full-time medical students on the medical campus. Part-time students, Danforth campus students and their dependents are not eligible to participate in the WUSM Student Health Service. A full-time student’s eligible Dependents may also participate in the service.
An eligible dependent is: a spouse or a domestic partner; the natural, adopted, or stepchildren of you, your spouse or your domestic partner and children for whom you, your spouse or your domestic partner are legal guardian, from birth to age 19. Your eligible dependents must reside with you 100% of the time (full custody), be dependent upon you for support and maintenance, and not be eligible for other coverage. If you elect to cover one dependent child, you must cover all of your dependent children.
- Spouse, domestic partner or dependent child of a student (as defined below) who resides with the student and who is not eligible for coverage through his/her school or employer.
- Spouse, defined as an individual to whom the student is legally married, or a Domestic Partner, defined as an individual of the same or opposite sex with whom the student has established a domestic partnership. A domestic partnership is a relationship between a student and one other person of the same or opposite sex. Both persons must:
- not be so closely related that marriage would otherwise be prohibited;
- not be legally married to, or the Domestic Partner of, another person under either statutory or common law;
- be at least 18 years old;
- live together and share the common necessities of life;
- be mentally competent to enter into a contract; and
- be financially interdependent.
In order to cover a Domestic Partner, a student must complete a domestic partner affidavit.
Dependent child(ren), defined as the student’s child, the Spouse’s child, or the Domestic Partner’s child, as long as the child:
- is under 19 years of age and dependent upon the student for support and maintenance; and
- is the student’s biological child, stepchild, legally adopted child, or a child placed with the student for adoption, or a child for whom the student and/or his or her Spouse or Domestic Partner is the legal guardian; and
- resides with the student 100% of the time during the policy year (full custody); and
- is not eligible for coverage as a dependent of someone other than the student, provided that this requirement shall not apply if both parents are covered by the WUSM program; and
- does not qualify for coverage through Medicaid and the Children’s Health Insurance program.
- If a student elects to have a Dependent Child covered by this health program, then all eligible Dependent Children of the student must be covered by this health program, and the appropriate health service access fee for each covered Dependent Child must be paid.
- All Dependents (Spouses, Domestic Partners, and Dependent Children) must provide proof of prior continuous creditable coverage over the six months immediately preceding coverage through the WUSM program.
At the time of orientation, all new students will be given a Medical Benefit Identification card. This card should be shown to all caregivers outside of Student Health Services to ensure proper billing. If you need a replacement card, you may pick one up at Student Health Services.
Coverage dates (begin/end dates)
Benefits are payable under this program only for those Covered Medical Expenses incurred while the Program is in effect. No benefits are payable for expenses incurred after the date the benefits terminate. This program terminates for all covered Dependents once the student is no longer covered or if the Student Health Service access fee for covered Dependents has not been received. There will be a thirty-one (31) day grace period for late payment of the access fee, after which time, coverage for the student’s Dependents will be terminated. If Dependent coverage is terminated due to lack of sufficient payment, coverage for any Dependents of that student will not be allowed at any time in the future.
If a student elects to enroll his or her covered Dependents at matriculation, coverage for Dependents will become effective on the same date the covered student’s benefits become effective, provided enrollment for the Dependents occurs on or before the deadline. No enrollment for Dependents is allowed after the deadline unless a Qualifying Event occurs. When Dependents, other than newborns, join based on a Qualifying Event, their coverage becomes effective as of the first of the month following the Qualifying Event as long as appropriate payment of the Student Health Service access fee has been provided. Newborns entering the program as a Qualifying Event will have coverage effective retroactive to the date of birth. Dependent coverage terminates when the student’s coverage terminates or when the dependent no longer meets the definition of a Dependent as described above, if earlier.
All outpatient Student Health Services benefits take effect on the date of the student’s registration with Student Health (if all Health Requirements are met) and continue so long as the student maintains full-time student status. These benefits cease the date the student withdraws, graduates, or completes a course of study by submitting thesis paperwork to the appropriate office.
Hospital and emergency room services
Hospitalization and emergency room benefits take effect on the date of the student’s registration with Student Health (if all Heath Requirements are met) and continue as long as the student maintains full-time student status and for an additional 30 days after the student graduates, withdraws, or completes a course of study by submitting all thesis paperwork to the appropriate office. Notwithstanding the foregoing, if a student graduates at the conclusion of the spring semester, hospitalization and emergency room benefits continue until July 1 or the date the student’s internship begins, whichever comes first.
Away from campus
Special rules apply when the student is away from campus. There are limited benefits provided through Student Health Services, which are described later in Travel Information.
Graduating or leaving the University
Dependents terminate in accordance with the termination provisions described above. Examples include, but are not limited to the date the student’s coverage terminates or the date the Dependent no longer meets the definition of a Dependent. Letters of coverage are supplied upon request.
When a student graduates or leaves Washington University, Assurant Health has insurance plans designed for students and family who are no longer covered under their parents’ health plan or their university student medical benefits. If you need information on medical insurance coverage going forward, you may wish to contact Assurant Health.
Travel outside the U.S.
Student Health Services does not provide any coverage for you or eligible Dependents when traveling outside of the United States. You are encouraged to take advantage of the medical plan for international travel and you may obtain more information on that plan from Student Health Services.
Leave(s) of absence
Limited Student Health Services benefits are available during a leave of absence. If you want to continue Student Health Services benefits while on a leave of absence, you will be required to pay the Student Health Services access fee, in addition to the deductibles and co-payments paid by active students. The student and his or her dependents are only eligible to remain on the Student Health Services program if they have completed a full 30 days of enrollment. The Student Health Services fee must be paid within 30 days of the effective date of the leave and, thereafter, is required to be paid monthly, in advance, at the beginning of the calendar month. If Student Health Services does not receive payment within five days of the beginning of the month, coverage will terminate. Coverage is reactivated upon return to active status. The maximum amount of benefits provided while on leave is $85,000 per person covered, and the life insurance benefit (described later in this booklet) is suspended, if full-time student status is not maintained while on leave. Student Health Services benefits are available to a student on leave for a maximum of 24 months (which need not be consecutive).
Students requiring a personal leave of absence for medical reasons must submit a supporting letter from the Director of the Student Health Service.
Spouses, domestic partners, and dependent children enrolled in the Student Health Services program may remain enrolled in the program while the student is on an approved leave of absence as described above, as long as all other criteria for enrollment are met.