Medical

What You Need to Know

If you are covered by UC SHIP, you need a referral from Student Health and Counseling Services (SHCS) to get care anywhere else — except for emergency room care, urgent care clinic visits, pediatric care, obstetrics services, gynecological care, and LiveHealth Online virtual visits.

If needed, SHCS will provide a referral for services it can’t provide.

What You Pay for Care

    You’ll pay nothing for preventive care at SHCS, and low copays for other services and procedures.

    Except for preventive care, you will pay a deductible for services you receive outside SHCS or the UC network of doctors and facilities, unless otherwise noted. After you meet the deductible, the plan will pay a portion of the cost. If you receive any care from an out-of-network provider, you will be responsible for your coinsurance plus any amount above the maximum allowable charges.

    You’ll always pay more when you receive care from providers who are not part of the UC SHIP or Anthem Blue Cross Prudent Buyer PPO networks.

    Based on where you receive care, here’s what you can expect to pay for typical health care services. Note: Office visit copays do not include what you’ll pay for other services, such as lab work and X-rays. For coverage details, including expenses and services the plan does not cover, see the UC San Francisco Benefit Booklet [PDF].

    You Need a Referral for Care Outside the SHCS

    If you are covered by UC SHIP, you need a referral from Student Health and Counseling Services to get care anywhere else — except for emergency room care, urgent care clinic visits, pediatric care, obstetrics services, gynecological care, and LiveHealth Online virtual visits.

    Inside SHCS

    Benefit-Year Deductible
    You Pay
    $0
    Limits on Your Out-of-Pocket Costs (combined with UC Family costs)
    You Pay
    Individual: $2,000
    Family: $4,000
    Office Visits (primary care)
    You Pay
    $01
    Routine Physicals/Adult Student Preventive Care
    You Pay
    $0
    Office Visits (mental health and substance use disorders)
    You Pay
    $0
    Urgent Care
    You Pay
    N/A
    Emergency Care
    You Pay
    N/A
    Inpatient Hospital Care
    You Pay
    N/A
    Lab Tests (e.g., bloodwork)
    You Pay
    5% coinsurance
    X-rays
    You Pay
    5% coinsurance
    Pediatric Dental and Vision Care (up to age 19)
    You Pay
    N/A
    1. You’ll pay additional charges for other services, such as lab work. For details, review the UC San Francisco Benefit Booklet [PDF].

    For more information about SHCS services, visit the Student Health and Counseling Services website.

    UC Family Providers

    UC Family providers include SHCS, UCSF Medical Center, and any other UC medical centers and their affiliated facilities and professional providers. Refer to the table above for specific SHCS-specific charges.

    Coverage
    Benefit-Year Deductible
    Limits on Your Out-of-Pocket Costs (combined with UC Family costs)
    Office Visits (primary care)
    Office Visits (specialty care)
    Routine Physicals/Adult Student Preventive Care
    Office Visits (mental health and substance use disorders)
    Urgent Care
    Emergency Care (non-admission)
    Inpatient Hospital Care
    Lab Tests (e.g., bloodwork)
    X-rays
    Pediatric Dental and Vision Care (up to age 19)
    You Pay
    $0
    Individual: $2,000
    Family: $4,000
    $25 copay1
    $10 copay1
    $0
    $0
    $25 copay
    $125 copay
    UCSF Medical Center: $0 copay
    All other UC Family providers: 5% coinsurance
    5% coinsurance, deductible waived
    5% coinsurance, deductible waived
    N/A
    1. You’ll pay additional charges for other services, such as lab work. For details, review the UC San Francisco Benefit Booklet [PDF].
    Anthem Blue Cross Providers
    Coverage
    Benefit-Year Deductible (all services except mental health)
    Benefit-Year Deductible (mental health)
    Limits on Your Out-of-Pocket Costs
    Office Visits (primary care)
    Office Visits (specialty care)
    Routine Physicals/Adult Student Preventive Care
    Office Visits (mental health and substance use disorders)
    LiveHealth Online
    Urgent Care
    Emergency Care (non-admission)
    Inpatient Hospital Care
    Lab Tests (e.g., bloodwork)
    X-rays
    Pediatric Dental Checkup (up to age 19)
    Pediatric Basic and Major Dental Services (up to age 19)
    Pediatric Vision Exam, Frame (formulary), Standard Lenses/Contact Lenses (up to age 19)
    You Pay
    Individual: $200
    Family: $400
    $0
    Individual: $3,000
    Family: $6,000
    $25 copay,1 deductible waived
    $40 copay,1 deductible waived
    $0, deductible waived
    $0, deductible waived
    Mental health and substance use disorders: $0 copay, deductible waived
    Medical, including urgent care: $25 copay, deductible waived
    $25, deductible waived
    $125, deductible waived
    10% coinsurance after $250 copay
    10% coinsurance
    10% coinsurance
    $0
    50% coinsurance
    $0
    1. You’ll pay additional charges for other services, such as lab work. For details, review the UC San Francisco Benefit Booklet [PDF].
    Out-of-Network Providers

    As a reminder, you must first meet your annual deductible before the plan begins to share costs with you.

    Coverage
    Benefit-Year Deductible (all services except mental health)
    Benefit-Year Deductible (mental health)
    Limits on Your Out-of-Pocket Costs
    Office Visits (primary and specialty care)
    Routine Physicals/Adult Student Preventive Care
    Office Visits (mental health and substance use disorders)
    Urgent Care
    Emergency Care
    Inpatient Hospital Care
    Lab Tests (e.g., bloodwork)
    X-rays
    Pediatric Dental Checkup (up to age 19)
    Pediatric Basic and Major Dental Services (up to age 19)
    Pediatric Vision Exam, Frame (formulary), Standard Lenses/Contact Lenses (up to age 19)
    You Pay
    Individual: $750
    Family: $1,500
    $0
    Individual: $6,000
    Family: $12,000
    40% coinsurance
    Not covered
    35% coinsurance, deductible waived
    40% coinsurance
    $125 copay, deductible waived
    40% coinsurance after $500 copay
    40% coinsurance
    40% coinsurance
    $0
    50% coinsurance
    100% after $30 exam allowance, $45 frame allowance, and $25 lens allowance

    We Cover Your Transition

    UC SHIP covers gender-affirming care.

    Finding Care Outside the SHC

    To find an Anthem network provider, visit the Anthem website and follow the steps below:

    1. Select Find Care at the top of the page.
    2. Select Guests unless you’re already registered with Anthem.
    3. Scroll down to What type of care are you searching for? and select Medical.
    4. Scroll down to What state do you want to search with? and select California.
    5. Scroll down to What type of plan do you want to search with? and select Medical (Student Health).
    6. Scroll down to Select a plan/network. In the drop-down menu, choose UCSHIP, and then click Continue.
    7. On the following page, insert your city (e.g., Riverside, CA).
    8. Scroll down to Search by Care Provider.
    9. To find a Primary Care doctor, select Primary Care.
    10. This will generate a list of Physicians & Medical Professionals. Select from those tagged Family Practice or Internal Medicine. These are the providers you can visit after you have received a referral from the SHC. You will need to contact the provider to confirm whether they are taking new patients.

    Contacts

    Student Health and Counseling Services (SHCS)