Counseling & Psychiatry Visits
| Patient Responsibility | UHS | Network Provider (outside UHS) | Non-Network Provider (outside UHS) |
| Counseling (short term) | $0 | $15 | 50%1, 2 |
| Psychiatry | $15 | $15 | 50%1, 2 |
Inpatient and Outpatient Services
| Patient Responsibility | Network Provider (outside UHS) | Non-Network Provider (outside UHS) |
| Inpatient & Residential Treatment Centers | 10%1 | 50%1, 2 |
| Intensive Outpatient Program & Partial Hospitalization | 10%1 | 50%1, 2 |
| Psychoeducational Testing | 10% | 50%2 |
1Services are subject to the $450 deductible (per plan year).
2If services are rendered with a non-network provider, SHIP covers 50% of the usual and customary charge after the deductible is met. All costs over the usual and customary charge is the member's responsibility.