Medi-Cal Recipients

If You Plan To Keep Medi-Cal and Waive SHIP

First make sure that your insurance provides coverage for non-emergency medical care within 50 miles of UC Berkeley. Avoid having your waiver denied and take the necessary steps now to make sure that you have the necessary coverage before you need to use it.

Get started on this process as soon as possible, especially if you need to transfer your Medi-Cal to a different county. Your waiver cannot be approved until your Medi-Cal coverage is active AND has assigned a primary care physician that provides non-emergency coverage in the Berkeley area prior to the start of the semester.

Which county is Medi-Cal sufficient to waive out of Berkeley SHIP?

The following county Medi-Cal programs can waive out of SHIP:
  • Alameda
  • Contra Costa
  • Marin 
  • San Francisco 
  • San Mateo
  • Santa Clara
If your assigned Medi-Cal provider is not from one of these counties, but is within 50 miles of campus, please contact the SHIP Office to discuss your individual waiver eligibility. 

How do I change my Medi-Cal county if I already have Medi-Cal?

Contact the Department of Health and Human Services in the county where your Medi-Cal was obtained. Explain you are attending college at UC Berkeley and may reside in your home county during vacations and school breaks. Please note it may take 30 days or more for your change request to be processed.

When a family informs their county that the Medi-Cal beneficiary attends college outside of the family’s residence county, the county should update only the student’s address and enter the new residence county information into the Statewide Automated Welfare System (SAWS) and the Medi-Cal Eligibility Data System (MEDS). This action will trigger the discontinuance of the student’s current health plan in the family’s residence county. You should then receive a package with information and steps on how to select a medical plan near Berkeley or you may call Medi-Cal Healthcare Options at (800) 430-4263 to complete the medical plan selection and provider assignment process.  

During the new plan selection and enrollment process in the new county, students can continue to use the same Benefits Identification Card to obtain health care services and have access to Fee-for-Service Medi-Cal providers only until the new health plan enrollment is completed. Please note, locating a Fee-for-Service Medi-Cal provider, who is accepting new patients, may be difficult.

What if I want to apply for Medi-Cal but haven’t yet?

Your Medi-Cal must be active in a county within 50 miles of campus and have an assigned primary care provider on or before August 1 (for Fall waivers) or January 1 (for new Spring waivers). To determine Medi-Cal eligibility, please visit My Benefits California or contact the California statewide Medi-Cal office at (800) 541-5555.

How do I contact Medi-Cal?

You may find these external contacts helpful:

Can I use Medi-Cal to pay for services at the Tang Center?

All eligible registered students may receive services at University Health Services (UHS). However, you will be charged for services and UHS will not bill Medi-Cal. Please be advised, in most circumstances Medi-Cal will not reimburse for care received at Tang.

Pell Grant and Dream Aid recipients are eligible for the Health Opportunity Fund to help offset some expenses at Tang. Please note this is not tied to insurance plans, but to fees for services within the Tang Center (excluding Optometry). 

Why should I keep SHIP if I have Medi-Cal?

Financial Aid often covers or sets aside money strictly used for SHIP fees. Before applying for a waiver, please inquire with Cal Student Central at (510) 664-9181 to find out if SHIP is or can be included in your FinAid package. If SHIP is included and you waive out, your financial aid package will be adjusted and you will not be allowed to use the aid towards other fees.  Please carefully consider your decision to waive.

Please note, while all eligible registered students may use the Tang Center (UHS) for services, UHS does not bill Medi-Cal and Medi-Cal is unlikely to reimburse you for services provided at Tang. 

What if I don’t change my Medi-Cal county to be within 50 miles of campus?

We audit at least 25% of waivers, including all Medi-Cal and HMO plans. If you are using Medi-Cal as an alternate plan, you must submit a local Medi-Cal insurance card and a local assigned primary care provider must be listed on the card or a Kaiser insurance card from Northern California. All students who have not been assigned a local Medi-Cal provider or are still in the process of transferring counties will be enrolled in SHIP without the opportunity to appeal. There is no proration for students added to SHIP in the middle of the semester.

What if my Medi-Cal gets terminated?

If your Medi-Cal is terminated, you may enroll in SHIP at any time during the semester. Please complete a waiver reversal via the eTang portal.

Can I keep both SHIP and Medi-Cal?

As Medi-Cal is the insurer of last resort, it is possible that Medi-Cal may discontinue your benefits if you choose to keep SHIP. No action is necessary if you choose to keep both SHIP and your Medi-Cal. Medi-cal will be secondary to SHIP as long as Medi-Cal agrees to continue providing coverage.

Will financial aid pay for SHIP if I do not waive out?

Financial Aid often covers or sets aside aid strictly used for SHIP fees. Before applying for a waiver, please inquire with Cal Student Central at (510) 664-9181 to find out if SHIP is or can be included in your FinAid package. If SHIP is included and you waive out, your financial aid package will be adjusted and you will not be allowed to use the money towards other fees. Please carefully consider your decision to waive.

Topics

Insurance topic page