I. All plans must provide unrestricted access to an in-network primary care provider, in-network hospital and full non-emergency medical and behavioral health care within 50 miles of campus or the student’s place of residence while attending school.
NOTE: This criterion applies to all plan types without exception, including Medi-Cal or Medicaid, Medicare, TRICARE/military, HMOs (including Kaiser, Sharp and others), Covered California, ministry sharing plans or other U.S. federal or state exchange plans, all employee-sponsored and individual plans. Plans with an assigned PCP must have one assigned within 50 miles of campus or the student’s place of residence prior to the start of the semester (Fall August 19, 2020 and Spring January 12, 2021).
|II. Coverage is currently active and the student agrees to maintain health coverage throughout the entire academic year 8/1/20-12/31/20 (fall) and 1/1/21-7/31/21 (spring). If your coverage is terminated, please contact the Student Health Insurance Office immediately.|
III. To satisfy UC’s health insurance requirement for enrolled students, the plan held by the student must meet all of the following criteria (this applies to all students regardless of gender):
1) Be a Medi-Cal/Medicaid, Medicare, TRICARE/Military, Covered California or other U.S. federal or state exchange plan, or a UC Employee Health Plan, OR
2) Be an employer-sponsored group health plan or individual plan that covers the following benefits:
a) Has an annual out-of-pocket maximum of $8,550 or less for an individual or $17,100 or less for a family. Deductibles, copayments, and coinsurance paid by the member accrue toward meeting the out-of-pocket maximum. A higher out-of-pocket maximum is allowed if the subscriber has a Health Savings Account (HSA) or a Health Reimbursement Account (HRA).
b) Inpatient (hospital) and outpatient care for mental health and substance abuse disorder conditions are the same as any other medical condition.
c) Doctor office visits for medical, including mental health and alcohol/drug abuse conditions.
d) Provides coverage for all Minimum Essential Health Benefits.
e) May not be a health care or pharmacy reimbursement plan (A reimbursement plan means the student must pay for services, then file a claim with the insurance provider for reimbursement).
f) Have no per medical or mental health/substance abuse dollar maximum limits.
IV. For international students, the following additional criteria apply. The plan must: