Using Your Health Plan

Enrollment

How do I enroll myself for health benefits?
Use 'MyUW' to enroll for benefits during your class registration process.

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.

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.

    I am enrolled in the ISHIP plan (annual or quarterly), how do I get my new spouse or baby added to the plan?
    If the addition of a dependent is within the Family Tier you specified at time of enrollment:

    1. Log on to the ISHIP Family Enrollment tool and add the necessary information.
      If the addition of a dependent requires you to change the Family Tier you specified at time of enrollment contact the ISHIP office and pay any additional money required.
    2. Or fill out an enrollment form and have the ISHIP office submit it to LifeWise Assurance Company (LifeWise)

    You must enroll your new dependent within 30 days of marriage or domestic partner registration, or within 60 days of birth or placement for adoption.

    If I enroll in “annual” insurance, what period of time does this cover?
    The annual plan provides 4 quarters of coverage (autumn, winter, spring, and summer quarters). The 2017-2018 plan runs from 9/1/2017 through 8/31/2018.

    If I don’t buy the annual plan in autumn quarter, can I buy it in a subsequent quarter?
    Yes. If the plan is not selected during autumn quarter, it can still be purchased by registered matriculated students for the remainder of the year at a pro-rated cost. For example: the annual plan purchased at winter quarter is for 3 quarters of coverage (winter, spring and summer quarters); the annual plan purchased at spring quarter is for 2 quarters of coverage (spring and summer quarters).

    Can I purchase summer quarter insurance if I didn’t select annual at an earlier quarter and I’m not a registered student during summer quarter?
    You must be either enrolled in annual coverage at an earlier quarter or registered for classes in summer quarter in order to have coverage during summer quarter. 

    Benefits & Coverage

    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.

    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.

    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.

    I am an international student and I tried to cancel my student insurance but couldn’t - why not?
    International students are required to enroll in the Student Health Insurance Plan. In certain circumstances, the International Students Services (ISS) office can waive this requirement. Contact the ISS office, room 459 Schmitz Hall; phone number 206-221-7857; website:  http://iss.washington.edu. If International Students and Scholars Office find that your insurance policy is adequate, they will contact our office and ask that we cancel the current quarter’s UW insurance plan.

    I need verification that I am enrolled in the student insurance plan. How do I do that?
    The University of Washington Student Insurance Office can provide the verification. You can visit their office at 459 Schmitz; email them at stdins@u.washington.edu; or call them at 206-543-6202. They can print out the verification for you to pick up at this office, email or scan it to your computer, or mail it to your address.

    How do I use my pharmacy benefits at Health Hall and other network pharmacies? 
    For more information, refer to your benefit booklet.

    Who are the network providers for this plan so I can get the highest percentage of coverage? 

    Find a network provider here.

    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 you do 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

    View the Prior Authorization Services List for more information.