Medical
What You Need to Know
If you are covered by UC SHIP, you need a referral from UCSF Health 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, UCSF Health will provide a referral for services it can’t provide.
What You Pay for Care
You’ll pay nothing for preventive care at UCSF Health, and low copays for other services and procedures.
Except for preventive care, you will pay a deductible for services you receive outside UCSF Health 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 San Francisco Benefit Booklet [PDF].
You Need a Referral for Care Outside UCSF Health
If you are covered by UC SHIP, you need a referral from UCSF Health 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 UCSF Health
Family: $9,000
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 UCSF Health services, visit the UCSF Health website.
UC Family Providers
UC Family providers include UCSF Health, UCSF Medical Center, and any other UC medical centers and their affiliated facilities and professional providers. Refer to the table above for specific UCSF Health-specific charges.
Family: $9,000
All other UC Family providers: 5% coinsurance
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
Family: $400
Family: $10,000
Medical, including urgent care: $25 copay, deductible waived
1. You’ll pay additional charges for other services, such as lab work. For details, review the UC San Francisco 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 Francisco Benefit Booklet [PDF].
Out-of-Network Providers
When you receive care from an out-of-network provider, you’ll need to pay out of pocket at the time of service, and then submit a claim to be reimbursed up to the following limits.
As a reminder, you must first meet your annual deductible before the plan begins to share costs with you.
Family: $1,500
Family: $18,000
We Cover Your Transition
UC SHIP covers gender-affirming care.
Finding Care Outside UCSF Health
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 SHC. 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.