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Benefits for Mills College Students 2007-2008:

Click here for benefits for 2008-2009.

Service and Supplies covered by SHIP:

Important -
Please Note:
  • 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. The deductible applies to all services described below except where noted.
  • If providers or facilities are used that are not part of the 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 $3,000 of out-of-pocket expenses each plan year. If you have paid $3,000 in co-insurance and deductibles (not including Pharmacy co-payments), you will no longer be required to pay co-insurance for the remainder of the plan year. The out-of-pocket maximum does not apply to amounts exceeding stated benefit limits (for example, Pharmacy or Physical Therapy limits) or to services not covered by the plan.
  • SHIP has a $250,000 lifetime maximum.
Inpatient Hospital Services
Including:
Medical Services
Mental Health
Maternity Services
Semi-Private Room

Pays 90% of Blue Cross Network rates,
80% of non-Network rates

Lab Tests, X-rays & Imaging Pays 90% of Blue Cross Network rates,
80% of non-Network rates
General supplies Pays 90% of Blue Cross Network rates,
80% of non-Network rates
Nursing services Pays 90% of Blue Cross Network rates,
80% of non-Network rates
Medication Pays 90% of Blue Cross Network rates,
80% of non-Network rates
Physicians & Specialists Pays 80% of 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.
  • 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 detoxification treatment is limited to 4 days per plan year.
Emergency Room Services
  • Emergency Room: Pays 100% of Blue Cross Network rates for treatment provided within 72 hours for injuries or sudden and serious illness, as determined by Blue Cross. Pays 80% of Blue Cross Network rates, or 60% of non-Network rates, for all other conditions.
  • Attending physicians and ancillary services: Pays 80% of Blue Cross Network rate or 60% of non-Network rate.
Outpatient Services
Physician office visits Pays 80% of Blue Cross Network rates, or 60% of non-Network rates
Lab Tests, X-rays, Imaging, Mammograms Pays 80% of Blue Cross Network rates, or 60% of non-Network rates
Maternity/Prenatal Care/Abortion Pays 80% of Blue Cross Network rates, or 60% of non-Network rates
Mental Health

Pays 80% of 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 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 805 of charge up to a maximum of $125.00 per plan year
Home Health visits Pays 100% of Blue Cross Network rates, or 80% of non-Network rates, up to 100 visits per plan year
Physical Therapy Pays 80% of Blue Cross Network rates, or 60% of non-Network, up to $1,000 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.

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 $2,000 coverage per plan year. See SHIP Pharmacy Benefits - Tracking How Much You've Used.

Allergy Testing & Injections Pays 80% of 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 MetLife. See Dental Coverage.
Dental Injury Pays 80% of 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 100% of customary and reasonable charges, up to $1,000 maximum per trip, if 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 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

Pays 80% of 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.

Glossary of Insurance Terms
Back to SHIP home page>

 

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