Students

Benefits for UC Berkeley Students 2014-15:Berkeley SHIP

As a registered student at Cal, you have an outstanding health plan available designed specifically for college students. Berkeley Student Health Insurance Plan (SHIP) is a comprehensive major medical insurance plan, providing medical, counseling and prescription through Aetna Student Health, vision through VSP and dental services through MetLife.

Important Notes:

  • SHIP coverage period: Fall August 15-January14, Spring January 15-August 14
  • All care must begin at University Health Services. With the exception of emergency or urgent care, all services must be authorized by the Student Health Insurance Office in order to ensure payment for services.
  • There is a $200 per plan year deductible for some medical services provided outside of UHS. Services that require the deductible are noted below.
  • If providers or facilities are used that are not part of the Aetna Student Health Provider Network, claims will be paid at 60% of the non-Network rate (customary and reasonable), which is often significantly lower than the Network rate. For example, 90% coverage of the Network rate is going to be less costly to the patient than 60% coverage of the non-Network rate.
  • For 2014-15 plan year: New! Students are responsible for no more than $3,200 of out-of-pocket expenses each plan year. Co-pays for prescriptions, office visits outside of Tang, emergency room and urgent care now count toward the annual out of pocket maximum. If you have paid $3,200 in co-insurance for in-network services, you will no longer be required to pay co-insurance for the remainder of the plan year. The out-of-pocket maximum does not apply to services not covered by the plan.
  • Berkeley SHIP has no insurance caps, including no lifetime maximum.
  • Dependent plans are available for spouses and/or children of UC Berkeley students. Enrollment begins July 15. See here for details.

 

 

SHIP Premium
  Semester Annual
Graduate Students $1577 $3154
Undergraduate Students $1095 $2190
24/7 Advice Nurse Line
  • Weekday UHS Advice Nurse: During weekday hours, students can call the UHS Advice Nurse line to speak with one of our nurses by calling (510) 643-7197.
  • SHIP After Hours Nurseline: 24/7 access to Aetna nurse advice line at (800) 681-4065.
Inpatient Hospital Services
Including:
Medical Services
Mental Health
Maternity Services
Service Coverage
Semi-Private Room Pays 90% of Aetna Network rates, 60% of non-Network rates
Lab Tests, X-rays & Imaging Pays 90% of Aetna Network rates, 60% of non-Network rates
General supplies Pays 90% of Aetna Network rates, 60% of non-Network rates
Nursing services Pays 90% of Aetna Network rates, 60% of non-Network rates
Medication Pays 90% of Aetna Network rates, 60% of non-Network rates
Physicians & Specialists Pays 90% of Aetna Network rates, 60% of non-Network rates
Transgender surgery Pays 90% of Aetna Network rates, 60% of non-Network rates
Inpatient surgery Pays 90% of Aetna Network rates, 60% of non-Network rates
  • Inpatient hospital services are subject to the deductible.
  • Inpatient hospital care in connection with childbirth will be covered for at least 48 hours following a normal delivery (96 hours following a cesarean section).
  • Newborns are covered for the first 31 days from date of birth at 90% in network, or 60% non-network. A separate $200 deductible applies.
   
Emergency Room Services or Urgent Care Clinic (authorization is not required)
  • Emergency Room: Pays 100% after $100 co-pay (co-pay waived if admitted) of Aetna Network rates for treatment provided within 72 hours for injuries or sudden and serious illness, as determined by Aetna. Includes facility and professional services.
  • Urgent Care Clinic: Pays 100% after $50 co-pay for Aetna Network provider, not subject to the deductible. Plan pays 60% of non-Network rates (subject to deductible).
  • Attending physicians: Pays 100% of Aetna Network rate or 60% of non-Network rate.
   
Outpatient Services
Service Coverage
Medical Office Visit At University Health Services:
$15 co-pay for Primary Care and Specialists (authorization required for all Specialist visits)

Outside of University Health Services
(An authorization by a UHS Clinician is required prior to seeking services outside of Tang or your claims will be denied):

Pays 100% after $15 co-pay for primary care and specialty care from Aetna Network providers, not subject to the deductible. Plan pays 60% of the allowable non-Network rates, subject to deductible.
Adult Preventative Services Adult preventative services at University Health Services (including routine mammograms, Pap smears & prostate cancer screenings) covered at 100%. One per plan year. This benefit is not covered outside UHS.
Lab Tests, X-rays, Imaging, Mammograms At University Health Services:
Pays 90% of UHS rates

Outside of University Health Services:
(An authorization by a UHS Clinician is required prior to seeking services outside of Tang or your claims will be denied)

Pays 90% of Aetna Network rates, or 60% of non-Network rates.
Mental Health Office Visits At University Health Services:
After five free counseling visits, pays 100% after $15 co-pay; psychiatry visits pays 100% after $15 co-pay

Outside of University Health Services
(An authorization by a UHS Clinician is required prior to seeking services outside of Tang or your claims will be denied):

Pays 100% after $15 copay for Aetna Network providers, not subject to the deductible. Plan pays 60% of non-Network rates, subject to deductible.

Maternity/Prenatal Care/Abortion Prenatal: $15 co-pay (deductible waived for network providers only) for first visit; 100% covered for subsequent visits in-network.
Maternity: 90% in-Network; 60% non-Network
Abortion: 90% in-Network; 60% non-Network
Acupuncture Pays 100% after $15 co-pay (deductible waived for network providers only).

An authorization by a UHS Clinician is required prior to seeking services outside of Tang or your claims will be denied.

Chiropractic Services Pays 100% after $15 co-pay (deductible waived for network providers only).

An authorization by a UHS Clinician is required prior to seeking services outside of Tang or your claims will be denied.

Podiatric Services Pays 90% Aetna Network rates, or 60% of non-Network rate.

An authorization by a UHS Clinician is required prior to seeking services outside of Tang or your claims will be denied.

Home Health Visits Pays 100% in Aetna Network; 60% of non-Network rates.
Physical Therapy, Physical Medicine, Occupational
Therapy and Speech Therapy
Pays 100% after $15 co-pay (deductible waived) for services at University Health Services or with an Aetna network provider. Pays 60% for non-Network provider (subject to deductible).

An authorization by a UHS Clinician is required prior to seeking services outside of Tang or your claims will be denied.

Prescription Drugs At University Health Services:
Prescriptions filled at the UHS Pharmacy have a $5 co-pay for generic and $25 co-pay for brand name medications (30-day supply). Birth control is covered at 100%; some conditions apply.

Outside of University Health Services:
Prescriptions filled outside of UHS have a $5 co-pay for generic and $25 co-pay for brand name medications (30-day supply), $40 for "non-formulary" items.

No prescription medications are subject to the deductible.

Allergy Testing & Injections Pays 90% of Aetna Network rates, 60% of non-Network rates
Dental Care SHIP members receive dental coverage through MetLife. See benefits here.
Dental Injury Pays 90% of Aetna Network rates for injury to natural teeth.
Ambulance - Ground Pays 90% of customary and reasonable charges if patient receives emergency care or is hospitalized.
Ambulance - Air Pays 90% of customary and reasonable charges, if patient receives emergency treatment or is hospitalized.
Urgent Care At University Health Services:
$30 co-pay for Urgent Care clinic visit

Outside of University Health Services:
Pays 100% after $50 co-pay for Aetna Network provider, not subject to the deductible. Plan pays 60% of non-Network rates (subject to deductible).

Skilled Nursing Facility Pays 90% of Aetna Network rates, or 60% of non-Network rates
Durable Medical Equipment Pays 90% of rental or purchase of medical equipment and supplies that are ordered by a Physician and are of no further use when medical need ends, when obtained
from a durable medical equipment supplier, including rental or purchase of diabetic equipment and supplies (excluding insulin).
Immunizations

(routine immunizations are recommended to be administered at UHS)

Pays 100% of University Health Services charges or Aetna Network rates, or 60% of non-Network rates, for the following immunizations:
Diphtheria/Tetanus/ Pertussis, Measles, Mumps and Rubella; Meningococcal; Varicella; Influenza; Hepatitis A and Hepatitis B; Pneumococcal; Polio; and Human Papillomavirus. TB testing/screening covered 100%. Routine immunizations are recommended to be administered at UHS. Flu shots are NOT covered when obtained at a pharmacy.

All other immunizations covered at 90% of charge at University Health Services or 90% of Aetna Network rates or 60% of non-Network rates.
Medical Evacuation The plan pays necessary expenses up to $10,000 for return to your home country when prior authorization has determined medical necessity through Aetna Student Health’s On Call program.
Repatriation If you die while enrolled in SHIP, the plan pays necessary expenses up to $7,500 to prepare your remains and transport your body to your home country.
Vision Care Vision Care is provided through VSP, available primarily at both UC Berkeley School of Optometry clinics on campus (Tang Center and Minor Hall). See vision benefits here.

Glossary of Insurance Terms
Back to SHIP home page>

University of California seal

Contact Info bullet Join Our Team bullet About UHS bullet Gifts bullet

Privacy Practices bullet Disclaimer bullet Tang 101 Video bullet Meet the Staff
Copyright © UC Regents bullet 2222 Bancroft Way, University of California, Berkeley, 94720-4300