Medical

What You Need to Know

If you are covered by UC SHIP and within a 50-mile radius of campus, you need a referral from the Student Health Services (SHS) 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, the SHS will provide a referral for services it can’t provide.

What You Pay for Care

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

    Except for preventive care, you will pay a deductible for services you receive outside the SHS 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. What you pay for medical costs counts toward your combined medical and pharmacy annual out-of-pocket limit. Once your costs reach that limit, UC SHIP will pay 100% of your medical and pharmacy costs for the remainder of the year.

    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 Riverside Benefit Booklet [PDF].

     

    You May Need a Referral for Care Outside the SHS

    If you are covered by UC SHIP and within 50 miles of campus, you need a referral from the SHS 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 the SHS

    You Pay
    Benefit-Year Deductible
    $0
    Annual Limits on Your Out-of-Pocket Costs (Costs accumulate together with network provider costs.)
    Individual: $4,500
    Family: $9,000
    Office Visits (primary and specialty care)
    $01
    Routine Physicals/Adult Student Preventive Care
    $0
    Office Visits (mental health and substance use disorders)
    $0
    Urgent Care (same-day walk-in)
    $0
    Emergency Care (non-admission)
    N/A
    Inpatient Hospital Care
    N/A
    Lab Tests (e.g., bloodwork)
    N/A
    X-rays
    N/A
    Pediatric Dental and Vision Care (up to age 19)
    N/A
    1. Additional charges for other services, such as lab work. For details, review the UC Riverside Benefit Booklet [PDF].

    For more information about SHS services, visit the Student Health Services website.

    Network Providers

    Network providers are those in the Anthem Blue Cross Prudent Buyer PPO network, including UC Family medical centers, affiliated facilities, and professional providers.

    Benefit-Year Deductible (combined with out-of-network providers)
    Annual Limits on Your Out-of-Pocket Costs (Costs accumulate together with SHS costs.)
    Office Visits (primary and specialty care)
    Routine Physicals/Adult Student Preventive Care
    Office Visits (mental health and substance use disorders)
    LiveHealth Online
    Urgent Care
    Emergency Care
    Inpatient Hospital Care
    Lab Tests (e.g., bloodwork)
    X-rays
    Pediatric Dental and Vision Care (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
    Individual: $4,500
    Family: $9,000
    Graduate students: $15 copay,1 deductible waived
    Undergraduates: $17 copay,1 deductible waived
    $0, deductible waived
    $0, deductible waived
    Mental health and substance use disorders: $0, deductible waived
    Medical, including urgent care: $0 copay, deductible waived
    $50 copay, deductible waived
    $150 copay; copay waived if you are admitted
    10% coinsurance2
    10% coinsurance
    10% coinsurance
    $0
    50% coinsurance
    $0
    1. Additional charges for other services, such as lab work. For details, review the UC Riverside Benefit Booklet [PDF].
    2. An additional 25% penalty is assessed for services and supplies provided by an out-of-network hospital. For details, review the UC Riverside 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.

    Benefit-Year Deductible (combined with network providers)
    Annual 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: $200
    Family: $400
    Individual: $9,000
    Family: $18,000
    40% coinsurance
    40% coinsurance
    40% coinsurance
    40% coinsurance
    $150 copay; copay waived if you are admitted
    40% coinsurance after $500 copay
    40% coinsurance
    40% coinsurance
    $0
    50% coinsurance
    $0

    We Cover Your Transition

    UC SHIP covers gender-affirming care.

    Finding Care Outside the SHS

    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 SHS. You will need to contact the provider to confirm whether they are taking new patients.

    Virtual Care Through LiveHealth Online

    For convenient, nonemergency care wherever you are, have a virtual visit with a doctor via your smartphone, tablet or computer through LiveHealth Online.

    Contacts

    Anthem Blue Cross Network

    Member Services
    (866) 940-8306

    Student Health Services (SHS)

    Your first stop for care on campus
    Main number: (951) 827-3031
    Counseling and Psychological Services (CAPS): (951) 827-5531
    SHS website
    Student Health and Counseling Center (Building 834), 388 W. Linden Street, Riverside, CA 92507