SHIP -- What is it and why is it provided by the University?
To understand how SHIP works, it is important to understand that your health plan at UC Berkeley consists of two parts:
1. University Health Services (UHS)
University Health Services is a complete outpatient health center for students, providing medical, mental health and preventive care. Our clinicians serve as your primary care provider or "PCP" while you're at UC Berkeley. All eligible registered students may use the services of UHS, regardless of what type of major medical insurance they have. Services are supported by registration fees and are provided at moderate prices.
2. Berkeley Student Health Insurance Plan (SHIP)
The University of California requires that all students have major medical insurance, and provides the Berkeley Student Health Insurance Plan (SHIP) to meet this requirement. SHIP cover services at UHS including primary care and services outside UHS including hospitalization, off-campus or out-of-area care while traveling and some specialty services not available at UHS. SHIP also provides dental and vision coverage. Students are automatically enrolled in SHIP and the premium is charged on the Cal Central account.
Students can choose to keep SHIP or waive enrollment if they have comparable coverage. Most students keep their SHIP enrollment because it is a solid, comprehensive plan; it is convenient and provides coverage 12 months a year anywhere in the world, offers excellent benefits and is affordable. SHIP and UHS work hand-in-hand.
How does SHIP work?
Please see How to use SHIP.
When does SHIP coverage begin and end?
|Fall 2019||August 1, 2019-December 31, 2019|
|Spring 2020||January 1, 2020-July 31, 2020|
Registered Berkeley students who enroll in SHIP for the Fall and Spring semesters have year-round health insurance coverage.
Can I waive SHIP coverage?
When is the SHIP coverage and waiver period for Special Summer Programs?
If I waive SHIP, can I still use University Health Services at the Tang Center?
Yes, all eligible registered UC Berkeley students can be seen at University Health Services. All eligible registered students pay $15 for a primary care office visit and $35 for an urgent care clinic visit.
UHS only bills Berkeley SHIP and does not bill any other insurance providers.
If I am enrolled in SHIP can I go to any doctor I want?
University Health Services is the primary care provider for students enrolled in SHIP. This means that you should see a UHS clinician when you need medical attention, unless you are away from campus or need to visit an emergency room or urgent care. We encourage students to see the same doctor or nurse practitioner for each visit, if possible. Knowing your clinician makes visits more comfortable and contributes to the most healthful outcome.
Should you need services not offered at UHS, your clinician will refer you to an off-campus health care provider (referral). Your UHS clinician may suggest a specific provider or you can choose a provider. However, we strongly recommend that SHIP students see providers who belong to the Blue Shield network in California. Use of the Blue Shield network insures the least out-of-pocket costs to SHIP members. If you are going out of state, please use our provider serach tool to find an in-network provider (please note, we use Cigna's PPO network outside of California).
Gentle reminder: Don't get stuck with the bill! Please note that with the exception of emergency room or urgent care services, prescriptions, international services, and limited preventative and women's health visits, all referrals for off-campus care must be approved by the SHIP Office prior to receiving services or else the claim will be denied.
Can I use my SHIP at other UCs?
The Student Health Center (SHC) at each University of California campus gladly offers reciprocal access to its student health services to currently registered students from all other UC campuses under the same conditions that apply to its own students who are not enrolled in its campus Student Health Insurance Plan (SHIP).
Students may have to pay for medical care and get reimbursed from their insurance provider.
Are there deductibles with SHIP?
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 insurance coverage resumes. In-network medical and mental health office visits, emergency room visits, network urgent care center visits and prescriptions are not subject to the annual deductible.
Is there an annual limit to my out-of-pocket payments?
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 co-insurance 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 out-of-pocket maximum for out-of-network services and providers is $6,500.
Do I need proof of coverage (also called a Certificate of Coverage)?
The SHIP office can provide you with a Certificate of Coverage or Insurance Verification Letter.
What do I do if I have to go to the emergency room?
No referral from the SHIP Office is required for visits to an emergency room or urgent care center.
Please provide the facility with the actual or electronic version of your SHIP member card. See Emergency/Urgent care resources.
Services Prior to August 1: Claims provided to Anthem Blue Cross will be processed according to the SHIP benefits. All follow-up care must have an approved referral from the SHIP Office in advance of services being received.
Services On August 1 or later: California claims provided to Blue Shield will be processed according to the SHIP benefits. Outside of California, claims provided to Cigna will be processed according to the SHIP benefits as well. All follow-up care must have an approved referral from the SHIP Office in advance of services being received.
If I am outside of Bay Area, how do I obtain medical care?
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 preventative 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.
For services prior to August 1: You can visit the Anthem Blue Cross website to locate them. Your primary care provider will have to complete the referral approval request form for any additional services or to refer you to another specialist.
For services on August 1 or after: You can visit the Wellfleet provider finder tool to find an in-network provider. Your primary care provider will have to complete the referral approval request form for any additional services or to refer you to another specialist.
For out of country claims: For more information on using SHIP abroad, please see this guide.
What do I do if I receive a medical visit bill?
If you receive a medical bill and the provider has not billed the plan, please call the number on the bill and give them your SHIP member number and ask them to re-bill the claim directly to the plan. Please see below to obtain your SHIP ID card. SHIP members do not file a claim for services at UHS that have fees. At the time of service, patients will pay only the fees for which they are responsible, usually 10% of the total charges. UHS will then file a claim with SHIP for payment of the remainder of the charges.
How do I obtain an insurance card?
Insurance cards will be mailed out to all students on SHIP about 3 weeks after the effective date. You can also view and print your ID card by registering at berkeley.wellfleetinsurance.com/SHIP