Enrollment
I have a TA/RA/SA appointment. Where do I get information regarding my appointment)?
The UW Benefits Office is the plan contact at the University of Washington and can handle questions regarding your appointment. Their phone number is
206-543-4444 and their email address is
uwgaip@uw.edu. General information about GAIP can be found at:
www.washington.edu/admin/hr/benefits/insure/gaip/index.html.
For questions about coverage or claims please contact LifeWise Customer Service at
800-971-1491.
I have a GAIP eligible appointment, but have already signed up for student insurance. What do I need to do?
Neither the Graduate Appointee Insurance Program (GAIP) nor the Student Health Insurance Plan (SHIP) allows for dual coverage. You can cancel the student insurance plan on MyUW or in person at the Student Fiscal Services Office prior to the 3rd
Friday of the quarter. If it’s past the 3rd Friday of the quarter, you need to contact the Benefits & Work/Life and ask them to confirm that you do have a GAIP eligible appointment this quarter. If you’ve already paid for the student insurance, your
student account will be credited; if unpaid, the charge will be dropped. There are some situations when the student insurance plan will automatically be canceled. Much depends on the timing of the TA/RA/SA appointment being entered in the payroll
system. Important Note: if you purchased annual coverage under ISHIP you may not re-apply for the ISHIP plan until the next Fall quarter.
What is a qualifying event?
A qualifying event allows you to enroll dependents outside of the regularly scheduled enrollment period. Examples of qualifying events are marriage and birth or adoption of a child.
How do I add my spouse or baby to my plan?
Once you are enrolled with LifeWise Assurance Company (LifeWise) you will receive documentation on how to enroll your dependents via the web. To add a dependent based on a qualifying event, you must contact LifeWise directly within 30 days of
marriage or domestic partner registration, or within 60 days of birth or placement for adoption.
I’ve enrolled my dependent. How do I make a correction to their personal information (name, birth date, address, credible coverage, etc)?
Please call LifeWise Customer Service at
800-971-1491 for assistance with this request.
Benefits & Coverage
Do I have to pay the doctor on the same day of service, or will the doctor bill the claims office first?
Listed on your ID card is the group number for your plan; give the group number to your provider. It’s a good idea to print a medical claim form to give to your provider and ask the provider if they will bill LifeWise directly.
What happens after I see a medical provider?
You will receive an Other Coverage Questionnaire with your welcome packet, please fill it out and return it to avoid a delay in processing your claims. If LifeWise hasn’t received your Other Coverage Questionnaire prior to the first time you
use your plan, you’ll receive another copy of the form via mail asking if you are insured by any other insurance plans. If not, simply check the box that indicates NO, sign and date the form, and return it to the claims office. If you are insured
by another plan, you’ll need to provide information about the plan. The information you provide will allow LifeWise to begin processing your claims. You may be mailed additional forms from LifeWise. Please be sure to respond to these mailings so your
claims can be processed efficiently. If you do not return the requested form(s), your claim(s) will not be processed.
Who are the network providers for this plan so I can get the highest percentage of coverage?
For medical benefits the network providers in our local area are:
Find a
network provider here.
For dental and vision benefits there are no network requirements and you may see any licensed provider. LifeWise contracts with many dentist and optometrist and if you visit one of these providers you will not be balance billed for the charges in excess
of the allowed amount.
How do I use my pharmacy benefits at Hall Health and other network pharmacies?
Refer to your
benefit booklet for more information on pharmacy benefits.
How do I file a complaint or appeal a claim?
You may appeal any LifeWise decision you find unacceptable. And you may file an appeal related to a complaint that was not resolved to your satisfaction.
Here’s how: Mail us a letter stating your intention to appeal a LifeWise decision. Describe the circumstances of your situation with as much relevant detail as possible. Please provide us with your name, member identification number, current
address, and telephone numbers where we may contact you during business hours.
For more detailed information please see the Claims Appeal Information form located on our
forms page.
What if I require medical care outside of the local area?
Your plan includes the LifeWise Assurance Company network of providers for Washington, Oregon and Alaska. LifeWise contracts with MultiPlan/PHCS network for national coverage. When you visit a LifeWise Assurance Company or MultiPlan/PHCS provider
you’ll simply present your ID card. Outside the U.S., you’ll have to pay medical expenses yourself and submit a claim form and documentation for reimbursement.
What do I need to know about Prior Authorization?
If you get a medical service that requires prior authorization without obtaining prior authorization, you may be liable for the entire cost of the service if it is not medically necessary.
NOTE: If your provider does not get a required prior authorization, LifeWise Assurance Company will still review the services to see if they are covered.
You may be required to pay the full cost of the service if:
- The service is not covered
- The service was performed by a provider outside the LifeWise network or state of Washington or Oregon and is not considered medically necessary