UCLA
Arthur Ashe Student
Health and Wellness Center

UCSHIP Medical & Prescription Benefits

UCSHIP has a lot to offer you. Take a look at the UCSHIP Student Brochure to learn more about the full range of benefits available to students with a UCSHIP policy.

Using Your Benefits

The Ashe Center serves as every UCSHIP student's Patient Centered Medical Home.

  • Student Members primarily enrolled in UC SHIP have an Ashe Primary Care Provider (PCP) at The Ashe Center who will manage health issues, medical problems, and preventive care.
  • Student Members are required to obtain a Student Health Center (SHC) Referral from The Ashe Center for all Specialty Care Services. The only exceptions to needing a referral are for emergency or urgent care, LiveHealth online, services provided by a pediatrician, obstetrician, or gynecologist.
  • Expenses will not be considered nor paid without a valid Student Health Center (SHC) Referral.

UCSHIP Medical Benefits are administered through Anthem Blue Cross. UCSHIP Prescription Benefits are administered through Optum Rx.

Click here for an infographic about how to use UCSHIP Medical Benefits.

Prescription Benefits On Campus

When students need to fill a prescription, we recommend going to the Bruin Health Pharmacy located in Ackerman Union (A-Level). They offer a full range of prescription and over-the-counter medications. The Bruin Health Pharmacy will always be their most affordable option for medications.

Bruin Health Pharmacy

Download the Sydney Health App

Sydney Mobile App - Anthem Video

Sydney Health Mobile App

UCSHIP Anthem Blue Cross

Plan Summary Benefit Booklet Summary of Benefits and Coverage Ashe Center Referral Information Coordination of Benefits Digital Insurance Card Medical Claim Form UCSHIP 'Where to Access Care' Guide

UCSHIP Anthem Blue Cross Benefits Summary 2024-25

Note: This is a high level summary of copays ($) and coinsurances (%). For more detailed information about this medical plan, reference the Summary of Coverage and Benefits and/or Benefit Booklet. To get a copy of the complete terms of coverage, visit MyUCSHIP.org or call UCSHIP Anthem Member Services at 1-866-940-8306.

*Non-emergent medical services must be initiated at The Ashe Center. Valid Ashe Referral required.

**Mental and Behavioral Health services must be initiated at UCLA Counseling and Psychological Services (CAPS). Valid CAPS referral required. Contact CAPS at 310-825-0768 or at www.caps.ucla.edu.

***Out-of-Network reimbursement is subject to usual and customary rates. Valid Ashe referral required for all non-emergent medical services.

† UC Family includes Ronald Reagan UCLA Medical Center, UCLA Medical Center, Santa Monica, UCI, UCSD, UCSF, and UCD.

Deductible & Out-of-Pocket Maximum 

The Ashe Center UC Family *† In-Network* Out-of-Network**
Deductible $0 $0 $300 $700
Out-of-Pocket Maximum $4,500 $4,500 $4,500 $9,000

Office Visits

The Ashe Center UC Family *† In-Network* Out-of-Network**
Primary Care $0 Not Available Not Available Not Available
Specialist $0 $15 $40 40%
Urgent Care Not Available Immediate Care $25 40%
Acupuncture $15 $15 $40 40%
Chiropractor Not Available Not Available $40 40%
Physical/Occupational Therapy $15 $15 $40 40%
Mental Health $0** $0** $0** 40%**

Lab & Imaging Services

The Ashe Center UC Family *† In-Network* Out-of-Network**
Lab & X-Ray
  • Lab: 10%
  • X-Ray: $10/
    per view
 15% 25% 40%
CT, MRI, Ultrasound, PET Scan Not Available 10% 20% 40%

Emergency Services

The Ashe Center UC Family *† In-Network* Out-of-Network**
Urgent Care $0 $25 $25 40%
Emergency Room Not Available $175 $175 $175
Hospitalization Not Available 10% $250 + 20% $500 + 40% + 25% penalty
Ambulance (Ground) Not Available 20% 20% 20%

UCSHIP Optum Rx

Formulary Plan Booklet Summary of Benefits and Coverage Prescription Reimbursement Request Form

UCSHIP Optum Rx Benefits Summary 2024-25

Note: This is only a summary. For more information about this prescription drug plan, reference the Summary of Benefits and Coverage and/or Plan Booklet. Network pharmacies include participating UC pharmacies and retail pharmacies in the OptumRx network, including CVS and Walgreens. For information on how to locate a Network Pharmacy in your area, contact Optum Rx 24/7 call center at 1-844-265-1879.

Bruin Health Pharmacy UC Family *† In-Network* Out-of-Network**
Generic $5 $10 $10 $10
Preferred Brand Name $25 $40 $40 $40
Non-Preferred Brand Name $40 $60 $60 $60
Specialty Drugs 10% up to $250 10% up to $250 10% up to $250 10% up to $250

Note: Covers up to a 30-day supply of medications and up to 180-days for oral contraceptives. Some oral contraceptives are available at no cost.