How to use SHIP

When you need medical care, call the appointment office at 510-642-2000 or visit MyUCBerkeleyHealth to make an appointment. Visit the appointments webpage for more information. 

Referrals 

As of March 16, 2020, and until further notice, no referrals are needed to obtain medical or mental health care outside of the Tang Center. 

SHIP Insurance Card

Please have your insurance card available when scheduling appointments as you will be asked for your plan details. You may also be asked to bring your insurance card to your appointment. 

Enrolled students may create a member account on the Aetna website or Aetna Health app to access their ID card. Additionally, students may request a PDF version of the ID card on the Aetna website to be sent to their email.  

Locate in-network medical and mental health providers 

SHIP is a nationwide plan and there are in-network providers across the country. To find in-network providers, visit the Aetna website and log into your member account or search as a guest in the "Open Choice PPO" network under "Student Health Medical Plans in California".

Using SHIP Abroad & Travel Assistance Services 

Please see our Using SHIP Abroad guide (pdf) for more information.

See SHIP referrals page.  

Emergency room and urgent care services do not require a referral. Please provide the facility with your insurance ID card. Claims submitted to the insurance provider will be processed according to the SHIP benefits.   

UHS bills Aetna directly for services provided at the Tang Center. Patients have the option to pay their financial responsibility (e.g., co-pay, co-insurance) at the Billing & Cashier Office.

• For office visits (e.g., primary care, urgent care), payments can be made immediately after your visit. 

• For labs and x-rays, payments can be made after 7 business days from the date of service.

Note: We will wait for Aetna to process claims before billing any unpaid patient responsibility portion to your CalCentral account.

Medical & Mental Health Services

When students receive care outside of the Tang Center, the health care provider may require payment of the student's portion of fees at the time of service, or they may send a bill after SHIP has paid the covered amount. Most providers will submit bills directly to Aetna.

If you receive a medical bill and the provider has not billed the plan for services, please call the number on the bill, give them your Aetna ID number, and ask them to re-bill the claim directly to Aetna.

Non-network Providers (including services outside the U.S.)

If you visited a non-network provider and paid out-of-pocket for services, you will have 365 days from the date of service to submit a claim for reimbursement. The claim form and itemized statement can be submitted to Aetna using any of the following methods:

• Aetna member portal
  
• Mail to PO Box 981106 El Paso, TX 79998
• Fax to (859) 455-8650

Prescriptions 

When filling prescriptions at a pharmacy, present your Aetna insurance card. If you paid out of pocket for a prescription, submit the Aetna prescription claim form for reimbursement using one of the following methods:

• Aetna member portal 
• Mail to PO Box 52444 Phoenix, AZ 85072-2444
• Fax to (888) 472-1128

Medical & Mental Health Services

When students receive care outside of the Tang Center, the health care provider may require payment of the student's portion of fees at the time of service, or they may send a bill after SHIP has paid the covered amount. Most providers will submit bills directly to Wellfleet's provider network (Blue Shield of CA for services in California or Cigna for services outside of California).

If you receive a medical bill and the provider has not billed the plan for services, please call the number on the bill, give them your Wellfleet ID number, and ask them to re-bill the claim directly to Blue Shield of CA for services in California or Cigna for services outside of California. 

Non-network Providers 

If you visited a non-network provider and paid out-of-pocket for services, you will have 365 days from the date of service to submit a claim for reimbursement. Complete and upload the claim form with the itemized statement(s) to your Wellfleet account or submit by mail, fax, or email provided on the top of the claim form.

Prescriptions 

When filling prescriptions at a pharmacy, present your Wellfleet insurance card. If you paid out of pocket for a prescription, submit the prescription claim form for reimbursement. 

International Claims

For out-of-country medical services and prescriptions, you will be required to pay upfront and submit a claim to Wellfleet within 365 days from the date of service for reimbursement. The claim form, along with the itemized statements, can be submitted online through your Wellfleet account or by mail, fax, or email. Note: If you reside outside the U.S., you may request reimbursements sent to your current location by providing your international address in the address field of the claim form.

Questions 

If you have questions or need assistance, contact the SHIP office at 510-642-5700 or ship@berkeley.edu.

Services provided at UHS is billed exclusively to SHIP regardless if you have dual coverage. Standard coordination of benefits practices apply to services outside of UHS. SHIP is the primary insurance for most students. For questions regarding coordination of benefits, contact Aetna Student Health Customer Service at (866) 639-3703. Note: If you also have Medi-Cal or Tricare, SHIP is primary.

There is a $450 plan year deductible for some services provided outside UHS. SHIP members are responsible for the first $450 of qualified charges outside of UHS each plan year. Once the deductible is satisfied, SHIP benefits begin.

The following services are not subject to the plan year deductible:

• Medical, mental health, and specialist office visits with network providers
• Urgent care center office visits
• Emergency room visits
• Outpatient prescriptions 

In-network

The individual in-network out-of-pocket maximum is $5,000. Applicable deductibles, co-pays, and co-insurances paid to in-network providers will accumulate towards the in-network out-of-pocket maximum. When the in-network out-of-pocket maximum is satisfied, SHIP will pay 100% for covered services with in-network providers for the remainder of the plan year. 

Out-of-network

There is a separate individual out-of-network out-of-pocket maximum of $10,000. Applicable deductibles, co-pays, and co-insurances paid to out-of-network providers will accumulate towards the out-of-network out-of-pocket maximum. When the out-of-network out-of-pocket maximum is satisfied, SHIP will pay 100% of the usual and customary charge for covered services with out-of-network providers for the remainder of the plan year. Non-covered services and charges over the usual and customary fee do not accumulate towards the out-of-pocket maximum and are the responsibility of the patient. 

Note:

1. The plan year is August 1 to July 31.
2. Out-of-pocket expenses to in-network providers do not count towards the out-of-network out-of-pocket maximum. 
3. Out-of-pocket expenses to out-of-network providers do not count towards the in-network out-of-pocket maximum. 

There is no lifetime maximum on the plan.

SHIP does not exclude pre-existing conditions. There is no waiting period for coverage for pre-existing conditions.

It is very important to keep your local address updated with the campus on CalCentral. When you move or go away for the summer, please remember to update your address.