SHIP Benefits

berkeley ship logoBerkeley Student Health Insurance Plan (SHIP) is an outstanding health plan designed specifically for college students.

Berkeley SHIP is a comprehensive major medical insurance plan, providing medical, counseling and prescription through Wellfleet Student, vision through VSP and dental services through MetLife.

Please note the benefit changes for 2021-22:  

  • Deductible: $450 for individuals; $1,350 for families 
  • Covered medical expenses incurred for the treatment of hypertension, diabetes, and pre/cervical cancer with network providers are not subject to the deductible, copay, or coinsurance. Note: prescription drugs are not included in this new benefit. See benefit summary below for prescription co-pays.
  • Travel assistance benefits provided through Academic Emergency Services. See this handout for more details. 

Important Notes:

  • Coverage periods:
    • Fall 2021: August 1, 2021 - December 31, 2021
    • Spring 2022: January 1, 2022 - July 31, 2022
  • There is a $450 per plan year deductible for some medical services provided outside of UHS. The plan year is from August 1 to July 31. 
  • If providers or facilities are used that are not part of in-network provider, claims will be paid at 50% of the non-network rate (customary and reasonable), which is often significantly lower than the in-network rate. For example, 90% coverage of the in-network rate is going to be less costly to the patient than 50% coverage of the non-network rate.

Benefit

In-Network Coverage Summary 2021-22 Plan Year

Preventative 100% covered (you pay $0)
Primary Care $15 co-pay for office visits
Physical Therapy $15 co-pay for office visits
Specialists $25 co-pay for office visits
Urgent Care $35 co-pay for visit, then 90% coverge for ancillary charges, $50 outside UHS 
Counseling No co-pay for short-term counseling from UHS, $15 co-pay outside of UHS
Nutrition $15 co-pay
Emergency Room $250 co-pay (waived if admitted; deductible waived)
Hospitalization $250 co-pay per admission then 90% coverage (you pay 10%) *subject to deductible
Labs/Tests/X-rays 90% coverage (you pay 10%) *subject to deductible outside UHS

Prescription Drugs

SHIP members are not required to use the UHS Tang Pharmacy.

Inside Tang:
  • $0 for generics
  • $25 co-pay for formulary brand
  • $40 co-pay for non-formulary
  • $75 co-pay for specialty

Outside Tang at Participating Retail Pharmacies:

  • $20 co-pay for most generics
  • $40 co-pay for formulary brand
  • $60 co-pay for non-formulary
  • 20%, up to $250 co-pay for specialty
Dental 100% coverage for exams and cleanings twice per year, 80% coverage for basic services, and 70% coverage for major services (up to $2,000 benefit maximum per year). $25 deductible applies to basic and major services.
Vision $10 co-pay for eye exam, $25 co-pay for frames and lenses (up to $150/year) or contact lenses (up to $150/year)
Deductible *$450 for some medical services outside of the Tang Center
Coronavirus Coverage
  • Coronavirus testing: Wellfleet will cover COVID-19 testing (sypmtomatic) until futher notice (including ER, telemedicine, urgent care and office visits) similar to a preventive benefit for fully insured plans, waiving co-pays, deductibles and co-insurance for customers when treated by in-network or out of network providers.
  • Coronavirus treatment: Wellfleet is waiving out-of-pocket costs for all COVID-19 treatment until further notice. The treatments that will be covered for COVID-19 are those covered under Medicare or other applicable state regulations. The company will reimburse health care providers based on in-network rates or reasonable and customary rates, as applicable.