Students

About UC SHIP: Frequently Asked Questions

UC SHIP 2012-13

 

Got questions? We've got answers!

 

UC SHIP --
What is it and why is it provided by the University?		 To understand how UC SHIP works, it is important to understand that your health plan at UC Berkeley consists of two parts:

1. University Health Services (UHS)
University Health Services is a complete outpatient health center for students, providing medical, mental health and preventive care. Our clinicians serve as your "family doctor" while you're at Cal. All registered students may use the services of UHS, regardless of what type of major medical insurance they have. Services are supported by registration fees and are provided at moderate fees.

2. The UC Student Health Insurance Plan (UC SHIP)
As voted in by students and passed by the UC Regents, the University requires that all students have major medical insurance, and provides the UC Student Health Insurance Plan (UC SHIP) to meet this requirement. While UHS (above) provides primary care to students, UC SHIP covers care outside of UHS, including hospitalization, off-campus or out-of-area care while traveling, and some specialty services not available at UHS. UC SHIP also provides dental coverage. Students automatically are enrolled in UC SHIP, and there is a charge on the CARS bill. Students can choose to keep UC SHIP, or they can waive enrollment if they have comparable coverage.

Most students keep their UC SHIP enrollment because it is a solid, comprehensive plan; it is convenient, it covers them 12 months a year anywhere in the world, offers excellent benefits, and is affordable. Also, UC SHIP and UHS work hand-in-hand, as discussed in the next question below.
How does UC SHIP work? As a student, most of the health care services you will need are available at University Health Services. When you need medical care, call or visit the Tang Center to make an appointment. Visit our Go Tang! website to find out more about how to get started at Tang. UC SHIP members pay $15 for a Primary Care office visit and $30 for an Urgent Care clinic visit. For most other services, UC SHIP members pay 10% of UHS fees. There are no claims to file for UHS visits.

If you need services at another health care facility, UC SHIP and UHS work together to provide a comprehensive health care plan, coordinating the care you need both on and off campus. UHS Clinicians will coordinate your medical services, and Student Health Insurance Office staff will provide authorizations for covered services and ensure that your claims are handled accurately. Don't get stuck with the bill! Please note that with the exception of Emergency Room care all referrals for off-campus care must be authorized by the Student Health Insurance Office prior to receiving services or else the claim will be denied. For off-campus care, UC SHIP contracts with Anthem Blue Cross to provide medical and mental health services through their extensive network of hospitals and providers. (See UC SHIP and Anthem Blue Cross -- What's the Connection?)

See How to Use UC SHIP resource page.

When does UC SHIP coverage begin and end?
  • Fall semester coverage begins August 15 and ends January 14 each year.
  • Spring semester coverage begins January 15 and ends August 14 each year.

Registered Berkeley students who enroll in UC SHIP for the Fall and Spring semesters have year-round health insurance coverage.
Can I waive UC SHIP coverage? Yes, if you have coverage through a major medical insurance plan comparable to UC SHIP. For waiver qualifications, instructions, forms, and FAQs, please see Waivers.
If I waive UC SHIP, can I still use University Health Services at the Tang Center?
 Yes, all registered UC Berkeley students can be seen at University Health Services. All students pay $15 for a Primary Care office visit and $30 for an Urgent Care clinic visit.
If I am enrolled in SHIP can I go to any doctor I want? University Health Services is the primary care provider for students enrolled in UC SHIP. This means that unless you are out of the country or need urgent care when the Tang Center is closed, you should see a UHS clinician when you need medical attention. We encourage students to see the same doctor or nurse practitioner for each visit, if possible. Knowing your clinician makes visits more comfortable and contributes to the most healthful outcome.

Should you need a service not offered at UHS, your clinician will refer you to an off-campus health care provider. Your UHS clinician may suggest a specific provider, or you can choose a provider. However, we strongly recommend that UC SHIP students see providers who belong to the Anthem Blue Cross Preferred Provider Network (PPO). Use of the Anthem Blue Cross PPO network insures the least out-of-pocket costs to UC SHIP members (see UC SHIP and Anthem Blue Cross - What's the Connection?).

Gentle reminder: Don't get stuck with the bill! Please note that with the exception of Emergency Room care all referrals for off-campus care must be authorized by the Student Health Insurance Office prior to receiving services or else the claim will be denied.

Can I use my UC SHIP at other UCs? The Student Health Center (SHC) at each University of California campus gladly offers reciprocal access to its student health services to currently registered students from all other UC campuses under the same conditions that apply to its own students who are not enrolled in its campus UC Student Health Insurance Plan (UC SHIP). However, UC Berkeley students with UC SHIP will receive health and counseling services at the same fees as UC SHIP enrolled students on the host campus. Host campus will submit claims on behalf of the visiting student to UC SHIP for covered services.
Are there deductibles with UC SHIP?
 There is a $200 plan year deductible for some services provided outside UHS. UC SHIP members are responsible for the first $200 of qualified charges outside of UHS each plan year. Once the deductible has been satisfied, UC SHIP benefits begin. Medical and mental health office visits, emergency room visits, urgent care center visits and prescriptions are not subject to the annual deductible. 
Is there an annual limit to my out-of-pocket payments?
 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 (excluding Pharmacy co-payments) to in-network providers, 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), out of network providers, or to services not covered by the plan.
What do I do if I have to go to the emergency room? No authorization from the Student Health Insurance Office is required for visits to an emergency room or urgent care center. Please provide the facility with your Anthem Blue Cross Card. Claims provided to Anthem Blue Cross will be processed according to the UC SHIP benefits.

All follow-up care must be authorized in advance by the Student Health Insurance Office.

UC SHIP pays 100% after $100 co-pay (co-pay waived if admitted) 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. UC SHIP pays 90% of Anthem Blue Cross Network rates, or 60% of non-Network rates, for all other conditions.

Pays 100% of Anthem Blue Cross Network rate for attending physician charges or 60% of non-Network rate. If you are admitted to the hospital, UC SHIP covers 90% of inpatient charges.
If I am outside of California, how do I obtain medical care? UC SHIP provides worldwide coverage through the BlueCard®Program. UC SHIP pays 100% after $100 co-pay (co-pay waived if admitted) 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. Includes facility and professional services (see Glossary for more about Customary and Reasonable rates). When requiring medical care in the United States, outside California, the provider of care should bill the Anthem Blue Cross affiliate in that state (pre-authorization is required on non-emergency medical visits). Traveling out of the country? See BlueCard® Worldwide website and Using UC SHIP Abroad (PDF).
What do I do if I receive a bill for a medical visit? If you receive a medical bill and the provider has not billed Anthem for services, please call the number on the bill and give them your Anthem 800 ID number and ask them to re-bill the claim directly to Anthem. If you don’t have your Anthem ID card or don’t have your 800 #, call Student Health Insurance Office at (510)642-5700 to obtain your number.

UC SHIP members do not file a claim for services at UHS that have fees. At the time of service, patients will pay only the fees for which they are responsible, usually 10% of the total charges. UHS will then file a claim with UC SHIP for payment of the remainder of the charges.

How do I obtain an Anthem Blue Cross insurance card? As a member of UC SHIP, you can expect to receive a white ID card from Anthem Blue Cross as proof of coverage. The card will be mailed to you at the local address held by the UCB Office of the Registrar within six weeks of enrolling in UC SHIP. Please take this card with you whenever you seek medical attention outside of UHS.

Before your permanent ID card arrives, you can print a temporary card online. Also, if your permanent card does not arrive within six weeks or if you should lose it, you can request a replacement permanent card.

Here's how to print a temporary card and/or request a new permanent card:

  • Go to the Anthem Blue Cross website. (The preceding link will open in a new window so you can refer back to these instructions.)
  • You will need to register and log in:
    • Click the Register button on the left.
    • Complete the registration process. Use your member ID (800-XXX-XXX -also located on the back of your Anthem Blue Cross insurance card) when registering.
    • Once you are logged in, you will be directed to a menu screen. Click the Request ID Card link.
  • Follow the on-screen instructions to complete the process of printing the temporary card and/or requesting a new permanent card.

Please direct questions to Wells Fargo Insurance Services to obtain your new Anthem ID # (800-853-5899) or call Anthem Blue Cross at 866-940-8306.

Can my dependents enroll in UC SHIP? Yes, we have a dependent plan option for children and spouses/domestic partners of students enrolled in UC SHIP. Also, see Insurance for Dependents for additional information and resources.

Dependents 17 years or older of registered UC Berkeley students may be seen at UHS on a fee for service basis.

Can I track how much of my annual pharmacy benefit I have used?
 Yes. See UC SHIP Pharmacy Benefits - Tracking How Much You've Used.
Still have questions? Please contact the Student Health Insurance office at 510-642-5700 or e-mail us at ship@uhs.berkeley.edu.

 

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