Medical
What You Need to Know
If you are covered by UC SHIP, you will 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. 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 Diego Benefit Booklet [PDF].
You Need a Referral for Care Outside the SHS
If you are covered by UC SHIP, 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
Family: $3,000
1. Additional charges for other services, such as lab work. For details, review the UC San Diego Benefit Booklet [PDF].
For more information about SHS services, visit the Student Health Services website.
UC Family Providers
UC Family providers include the SHS, the UC San Diego Health System, and any other UC medical centers and their affiliated facilities and professional providers. Refer to the SHS chart above for specific SHS charges.
Family: $3,000
All other: 10% coinsurance
1. Additional charges for other services, such as lab work. For details, review the UC San Diego Benefit Booklet [PDF].
Anthem Blue Cross Prudent Buyer PPO 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.
Family: $1,000
Family: $3,500
Medical, including urgent care: $20 copay, deductible waived
1. Additional charges for other services, such as lab work. For details, review the UC San Diego 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 San Diego 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.
Family: $2,000
Family: $7,000
1. Includes intensive medical care required by your condition, surgery, general anesthesia, newborn exams, diagnostic test interpretation.
2. Benefit-year deductible or copays may apply. See the UC San Diego Benefit Booklet [PDF].
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:
- Select Find Care at the top of the page.
- Select Guests unless you’re already registered with Anthem.
- Scroll down to What type of care are you searching for? and select Medical.
- Scroll down to What state do you want to search with? and select California.
- Scroll down to What type of plan do you want to search with? and select Medical (Student Health).
- Scroll down to Select a plan/network. In the drop-down menu, choose UCSHIP, and then click Continue.
- On the following page, insert your city (e.g., Riverside, CA).
- Scroll down to Search by Care Provider.
- To find a Primary Care doctor, select Primary Care.
- 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.