Students

Benefits for UC Berkeley Students 2010-11:

SHIP

This is information for the 2010-11 SHIP plan with coverage dates from August 15, 2010-August 14, 2011.
Click here to see benefits for the new UC SHIP 2011-12 plan.

The Student Health Insurance Plan (SHIP) is a comprehensive major medical insurance plan, providing medical, counseling, prescription, vision and dental services. Learn about how to use SHIP here (including claims and billing).

Important -
A few helpful reminders

  • All care must begin at University Health Services. All services must be authorized by the Student Health Insurance Office in order to ensure payment for services.
  • There is a $200 per plan year deductible for medical services provided outside of UHS.
  • If providers or facilities are used that are not part of the Anthem Blue Cross Prudent Buyer Provider Network, claims will be paid at 60% of the non-Network rate (limited fee schedule), which is often significantly lower than the Network rate. For example, 80% coverage of the Network rate is going to be less costly to the patient than 60% coverage of the non-Network rate.
  • Students are responsible for no more than $3,200 of out-of-pocket expenses each plan year.
  • SHIP has a $400,000 lifetime maximum.

 

Inpatient Hospital Services
Including:
Medical Services
Mental Health
Maternity Services
Service Coverage
Semi-Private Room Pays 90% of Anthem Blue Cross Network rates,
80% of non-Network rates
Lab Tests, X-rays & Imaging Pays 90% of Anthem Blue Cross Network rates,
80% of non-Network rates
General supplies Pays 90% of Anthem Blue Cross Network rates,
80% of non-Network rates
Nursing services Pays 90% of Anthem Blue Cross Network rates,
80% of non-Network rates
Medication Pays 90% of Anthem Blue Cross Network rates,
80% of non-Network rates
Physicians & Specialists Pays 80% of Anthem Blue Cross Network rates,
60% of non-Network rates
  • Inpatient hospital care in connection with childbirth will be covered for at least 48 hours following a normal delivery (96 hours following a cesarean section).
  • Newborns are covered for the first thirty days from date of birth, with a $25,000.00 lifetime maximum. As new plan members, newborns are subject to a separate $200 deductible and $3000 out- of-pocket maximum.
  • Coverage of mental health inpatient treatment is limited to 30 days per year, except as medically indicated for severe conditions covered by the Mental Health Parity Act of 2000.
  • Coverage of inpatient hospital alcohol and drug treatment is limited to 30 days per plan year. This limit does not apply to inpatient hospital services for detoxification during the acute phase of alcoholism or drug dependence.
   
Emergency Room Services
  • Emergency Room: Pays 100% of Anthem Blue Cross Network rates for treatment provided within 72 hours for injuries or sudden and serious illness, as determined by Anthem Blue Cross. Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates, for all other conditions.
  • Attending physicians and ancillary services: Pays 80% of Anthem Blue Cross Network rate or 60% of non-Network rate.
   
Outpatient Services
Service Coverage
Physician office visits Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates
Lab Tests, X-rays, Imaging, Mammograms Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates
Maternity/Prenatal Care/Abortion Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates
Mental Health Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates, for outpatient psychotherapy. For conditions not covered by the Mental Health Parity Act of 2000, covers a maximum of up to 25 visits per plan year, and visits are not subject to the deductible.

For psychological testing, medication monitoring, psychotherapy services and other conditions covered by the Mental Health Parity Act of 2000, pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates. These services are subject to the deductible.
Acupuncture Pays $25.00 per visit per day up to a maximum of $100.00 per plan year
Chiropractic services Pays $25.00 per visit per day up to a maximum of $100.00 per plan year
Podiatric services Pays 80% of charge up to a maximum of $125.00 per plan year
Home Health visits Pays 100% of Anthem Blue Cross Network rates, or 80% of non-Network rates, up to 100 visits per plan year
Physical Therapy Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network, up to $1,500 per plan year
Prescription Drugs Prescriptions filled at the UHS-Tang Center Pharmacy have a co-pay of $15 for generic and $25 for brand name medications (30-day supply). Hormonal contraceptives have a co-pay of $25 for 3 cycles. Click here for 2011-12 prescription benefit coverage.

Prescriptions filled outside of the Tang Center are reimbursed at 70% of billed charges.

No prescription medications are subject to the deductible. The pharmacy benefit is limited to a maximum of $7,500 coverage per plan year. See SHIP Pharmacy Benefits - Tracking How Much You've Used.
Allergy Testing & Injections Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates, up to $1,000.00 maximum per plan year
Dental Care SHIP members receive dental coverage through Delta Dental. See Dental Coverage.
Dental Injury Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates, for injury to natural teeth, up to $300.00 per injury, for services within 90 days of the date of injury
Ground Ambulance Pays 90% of customary and reasonable charges if the patient receives emergency treatment or is hospitalized.
Air Ambulance Pays 80% of customary and reasonable charges if patient receives emergency treatment or is hospitalized
Hospice Care Pays up to $5,000 maximum for patient's lifetime
Skilled Nursing Facility Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates, up to a maximum of 100 days per plan year
Durable Medical Equipment Pays 80% of rental or purchase of medical equipment and supplies which are ordered by a Physician and are of no further use when medical needs ends, when obtained from a durable medical equipment supplier, including rental or purchase of diabetic equipment and supplies (excluding insulin).
Immunizations

Routine immunizations are recommended to be administered at UHS		 Pays 80% of Anthem Blue Cross Network rates, or 60% of non-Network rates, for the following immunizations:
Diphtheria/Tetanus/Pertussis
Measles, Mumps and Rubella
Varicella
Influenza
Hepatitis A and Hepatitis B
Pneumococcal
Meningococcal
Polio
Human Papillomavirus
Medical Evacuation If you are in the U.S. on a non-immigrant visa and become unable to continue your academic program because of your medical condition, the plan pays necessary expenses up to $10,000 for return to your home country when prior authorization has determined medical necessity.
Repatriation If you are in the U.S. on a non-immigrant visa and die while enrolled in SHIP, the plan pays necessary expenses up to $7,500 to prepare your remains and transport your body to your home country.
Vision Care Vision care is provided through the UC Berkeley School of Optometry, at two clinics on campus and 11 other locations throughout California. See vision coverage

Glossary of Insurance Terms
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