When you need health care
With SHIP, all care must begin at University Health Services (UHS) (also known as the Tang Center). When you need medical care, simply call to make an appointment. SHIP members pay $15 for a primary care, physical therapy and gynecology office visit, $25 for specialty visit and $35 for an Urgent Care clinic visit at the Tang Center ($50 co-pay for in-network off-campus Urgent Care). For most other services, SHIP members pay 10% of UHS fees. There are no claims to file for UHS visits, and you will not have to pay any deductibles for any services at the Tang Center. Your primary care physician will provide you with a referral for any additional services that are not available at the Tang Center.
Don't get stuck with the bill! An approved referral is required prior to seeking services outside of Tang or your claims will be denied or penalized. Qualified emergency room care, urgent care, prescriptions, international services and limited preventive and women's health services are the only exceptions.
Referrals from UHS clinicians
See SHIP referrals page.
When you need health care outside of the area
All services outside the Tang Center require a referral from the SHIP office, except for emergency room or urgent care services, prescriptions, international services, and limited preventive and women's health services.
If you are out of the area and require care that is of medical necessity, please contact the SHIP office at (510) 642-5700 for an insurance referral. An approved referral will be provided to you for an office visit to an outside primary care physician. SHIP is a nationwide plan and there are in-network providers across the country. Your primary care physician will have to complete the referral approval request form for any additional services or to refer you to another specialist. To locate in-network providers see find providers from Wellfleet Student.
If you are out of the country, for more information on using SHIP abroad, please see the 2019-20 SHIP Abroad guide.
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. All follow-up care must be approved in advance by the SHIP office. Please visit the Tang Center primary care, urgent care or contact the 24/7 Advice Nurse at 510-643-7197 to submit the referral request.
Use your Wellfleet insurance ID card and submit your claims to Wellfleet.
SHIP does not exclude pre-existing conditions. There is no waiting period for coverage for pre-existing conditions.
Referral for services
Most non-emergency services provided outside of UHS must receive an approved referral prior to care or your claim may not be paid. Services outside UHS that do not require a referral include: services provided in a hospital emergency room or urgent care clinic, prescriptions, international services, and limited preventative and women's health visits. For all other non-emergency medical care outside UHS, see SHIP Referrals for more details.
Billing for services at UHS
UHS will bill Wellfleet directly for services provided at the Tang Center. At the time of service, patients will pay their co-pays. Some services will require students to pay 10% of the total service cost. This is not charged on the date of service but will be later billed to the student. Students can return to UHS within 21 days to pay their 10% charges or have the charges billed to their Cal Central account. The remainder of the charges will be billed to Wellfleet.
Billing for services outside UHS
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 network (in California this is Blue Shield; outside of California this is Cigna). If you receive a medical bill and the provider has not billed the plan for services, please call the number on the bill and give them your Wellfleet ID number and ask them to re-bill the claim directly to Blue Shield if in California or to Cigna if in another state. If you choose to visit a non-network provider, you will have 365 days to submit a claim for reimbursement. After August 1, submit a claim to Wellfleet.
For out of country claims: You will be required to pay upfront for the services and submit for reimbursement upon return. You have 365 days from the date of service to do so.
If you have questions or need assistance, please contact the SHIP office at 510-642-5700 or firstname.lastname@example.org.
There is a $300 plan year deductible for some services provided outside UHS. SHIP members are responsible for the first $300 of qualified charges outside of UHS each plan year. Once the deductible has been satisfied, SHIP benefits begin. Medical and mental health office visits, emergency room visits, urgent care center visits and prescriptions are not subject to the annual deductible.
Services provided at UHS will be billed exclusively to SHIP regardless if you have dual coverage through another plan in addition to SHIP.
For services provided outside of UHS, standard coordination of benefits practices apply. For most students, SHIP will be their primary insurance. An approved referral from the SHIP office will still be required in order to receive coverage through the plan. Please contact Wellfleet Member Services at (833) 302-9785.
Important reminder: If you also have Medi-Cal or Tricare, SHIP is always primary.
Annual out-of-pocket maximum
Students are responsible for no more than $3,200 of in-network out-of-pocket expenses each plan year. If you have paid $3,200 in coinsurance and deductibles to in-network providers, you will no longer be required to pay co-insurance for services obtained from in-network providers for the remainder of the plan year. The in-network out-of-pocket maximum does not apply to non-network providers or to services not covered by the plan.
The non-network out-of-pocket maximum for services and providers is $6,500.
There is no lifetime maximum on the plan.
Managing your plan - update your address
Updated address: It is very important that you keep your address updated with campus. For most students, your address should be updated through Cal Central. If you are a student worker, you may need to update your address in UC Path instead of Cal Central. Berkeley SHIP pulls your address from these systems. When you move or go away for the summer, please remember to update your address.