What are the medical benefits under UC SHIP?
The Student Health Insurance Plan (UC SHIP) works together with the on-campus Arthur Ashe Student Health and Wellness Center to provide you with the access to the care you need. Students covered by UC SHIP must begin non-emergency medical care at The Ashe Center. The Ashe Center will diagnose and treat most illnesses, coordinate all the insured person’s health care, and provide a referral when necessary to an Anthem Blue Cross network provider. If the UC SHIP student received medical care without an Ashe referral, the expenses will not be covered except for urgent care and a medical emergency. The referral does not guarantee payment; the services must be medically necessary and a covered benefit under this plan. The Ashe Center does not write retro referrals.
Plan benefits under UC SHIP for academic year 2014-2015:
routine preventive immunizations: Tetanus diphtheria/Pertussis,
Measles/Mumps/and Rubella, Meningococcal, Varicella, Influenza,
Hepatitis A and B, Pneumococcal, Anthrax, BCG, DTaP, Hib, Hib and DTP,
Japanese Encephalitis, MMRV, Rabies, Smallpox, Typhoid, Yellow Fever,
Zoster, Polio, and Human Papilloma Virus (subject to age limit) are
covered at 100% at The Ashe Center.
No annual or lifetime limits on medical and behavioral health benefits.
Coverage 365 days a year that goes with the student when travelling
room: pays 100% after $125 copay per visit (no Ashe Referral required)
at an Anthem network provider and UC Family medical center
Care: pays 100% after $25 copay per visit (no Ashe referral required)
at an Anthem network provider and UC Family medical center only when the
Ashe Center is closed.
Psycho-Educational testing: Learning disability assessment is covered up to $3,000 per lifetime
There are no caps on Essential Health Benefits (EHB) or pharmacy prescription drug benefits
The new medical plan includes a 3-tier structure:
1st Tier: Ashe Student Health Center and UC Family Medical Centers (UCLA, UCSD, UCI, UCSF, UCD)
- 10% co-insurance by the student or copayment for certain services ($15 specialist visit, $15 physical or occupational therapy)
- $2,000 annual Out-of-Pocket Maximum
2nd Tier: Anthem Network Providers
- 20% co-insurance by the student or copayment for certain services ($40 specialist visit, $40 physical or occupational therapy)
- $3,000 annual Out-of-Pocket Maximum
3rd Tier: Out-of-Network Providers
The Ashe Center serves as every UC SHIP student's medical home.
Medical services must be initiated at Ashe and Ashe referrals are
required for all non-emergent services outside of Ashe. Claims will not
be considered without the Ashe Center
referral. For details about the plan, visit www.ucop.edu/ucship.
Mental health/substance abuse services should be initiated at UCLA Counseling and Psychological Services (CAPS) and continued care will be referred to UCLA Behavioral Health Services.
Please refer to the website at : www.studenthealth.ucla.edu select insurance for the Anthem Blue Cross medical and vision and Delta dental brochures and plan summaries.