SHIP Medical Benefits

SHIP Medical Benefits: Patient Cost-sharing

Medical - Outpatient

Medical office, phone, & video visits1

UHS Network Provider (outside UHS) Non-Network Provider (outside UHS)2
Primary Care & Specialists $15 $15 50%3 

Note: If the visit is at a hospital setting, a facility (hospital) fee may apply. After the deductible, plan pays 80% for network rates or 50% non-network rates.

Adult preventative services & immunizations

UHS Network Provider (outside UHS) Non-Network Provider (outside UHS)2
Adult Preventive* Services $0 $0 50%3
Preventive Immunizations** $0 $0 50%3
Other Immunizations 20% 20%3 50%3

*Services include but not limited to, physical exams, preventive screenings, (including screenings for cancer, HPV, diabetes, cholesterol, blood pressure, hearing and vision), and immunizations.

**Preventive Immunization includes Diphtheria/Tetanus/ Pertussis, Measles, Mumps and Rubella; Meningococcal; Varicella; Influenza; Hepatitis A and Hepatitis B; Pneumococcal; Polio; Human Papillomavirus; Cholera; Typhoid; Yellow Fever; Japanese B. Encephalitis; and Lyme Vaccine.

NOTE: Routine immunizations are recommended to be administered at UHS. All immunizations must meet all FDA regulations prior to approval.

Labs, tests, x-rays, & imaging

UHS  Network Provider (outside UHS) Non-Network Provider (outside UHS)2
20% 20%3
 50%3

Abortion, prenatal care, maternity, breast pump, newborn, & fertility preservation


UHS Network Provider (outside UHS) Non-Network Provider (outside UHS)2
Abortion $0 $0 0%4
Prenatal care (including ultrasounds); comprehensive lactation support and counseling services; postnatal visits Not available $0 50%3
Breast Feeding Durable Medical Equipment (i.e., breast pump) Not available $0 50%3
Inpatient Care and Delivery  Not available $250 co-pay; then 20%3 $500 co-pay; then 50%3
Well-newborn nursery care at the hospital Not available 20% 50%
Fertility preservation Not available Fertility Preservation Benefits Flyer

Finding Ob/Gyn & Midwives
To locate 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".

Social Services at UHS

If you would like to discuss resources, get support services, or need help finding a provider, you may make an appointment with Social Services at (510) 642-6074. Social Services offers the following: 

  • Campus and community support services

  • Tips for managing early pregnancy symptoms and self-care before you see a doctor

  • Support on balancing your health care with your classes 

  • Referrals for family planning services, midwives, and obstetricians/gynecologists (Ob/Gyn)

  • Information on adoption if you are considering this option

  • Supportive counseling

Newborn Coverage

All newborn children must be reported to the Berkeley SHIP Office through MyUCBerkeleyHealth within 31 days from the date of birth. Please provide the baby’s full name, date of birth, sex, and proof of birth, and indicate if you would like to enroll your baby for the reminder of the SHIP term (after the 31 days). 

  • First 31 days: A child born to a SHIP member is covered for medically necessary health services for the first 31 days or until the student’s coverage terminates, if earlier.

  • Remainder of the semester term (after the first 31 days): Newborn coverage may be continued beyond the initial 31-day period with payment of additional premium.

For enrollment questions, refer to Qualifying Life Events or contact the SHIP Office at (510) 642-5700 or ship@berkeley.edu

Acupuncture & Chiropractic Care


Network Provider (outside UHS) Non-Network Provider (outside UHS)2
$25 50%

Physical Therapy, Occupational Therapy, & Speech Therapy

UHS Network Provider (outside UHS) Non-network Provider (UHS)2
Physical Therapy $15: then 20% $15; then 20%3 50%3
Occupational Therapy & Speech Therapy Not available $15; then 20%3 50%3

Allergy Testing & Injections

Network Provider (outside UHS) Non-Network Provider (outside UHS)2
20%3 50%3

Home Health Visits & Skilled Nursing Facility 

Network Provider (outside UHS) Non-Network Provider (outside UHS)2
20%3 50%3

Note: Home Health Care and Skilled Nursing Facility benefits are limited to 100 visits per policy year.

Durable Medical Equipment1

UHS Network Provider (outside UHS) Non-Network Provider (outside UHS)2
20% 20%3 50%3

For rental or purchase of medical equipment and supplies ordered by a physician and are of no further use when medical need ends. For breast pump coverage, please see maternity benefits. 

Equipment must be obtained from a durable medical equipment supplier, including rental or purchase of diabetic equipment and supplies (excluding insulin). 

Medical - Inpatient Hospital Services

  • Network Provider: $250 co-pay; then 20%1, 3
  • Non-network Provider: $500 co-pay; then 50%2, 3

Note: Inpatient hospital care in connection with childbirth will be covered for at least 48 hours following a normal delivery (96 hours following a cesarean section). 

Emergency Room, Urgent Care, and Ambulance

UHS Network Provider (outside UHS) Non-Network Provider (outside UHS)
Urgent Care $35 co-pay; then 20% $50 $506
Emergency Room Not available $250 (co-pay waived, if admitted)
Ambulance (Ground, Air & Water Transportation) Not available $0

Advice Nurse

  • UHS Advice Nurse: Students can speak with the UHS Advice Nurse by calling (510) 643-7197. 

Urgent Care + Emergency Room Locations

All listed centers are in-network providers, meaning SHIP will reimburse a portion of fees incurred after the co-pay.

Mental Health and Substance Abuse

Counseling & Psychiatry Visits 

Patient Responsibility  UHS Network Provider (outside UHS) Non-Network Provider (outside UHS)
Counseling (short term) $0 $15 50%2, 3 
Psychiatry $15 $15 50%2, 3
Inpatient and Outpatient Services
Patient Responsibility  Network Provider (outside UHS) Non-Network Provider (outside UHS)
Inpatient & Residential Treatment Centers 20%3 50%2, 3
Intensive Outpatient Program & Partial Hospitalization 20%3 50%2, 3
Psychoeducational Testing 20%3 50%2, 3

1No cost-sharing for covered medical expenses incurred for the treatment of hypertension, diabetes, and pre-cervical cancer with UHS and in-network providers.

2If services are rendered with a non-network provider, SHIP covers 50% of the usual and customary charge after the deductible is met. Members are responsible for all costs over the usual and customary charge.

3Subject to the $450 deductible (once per plan year).

4If services are rendered with a non-network provider, SHIP covers 100% of the usual and customary charge. Members are responsible for all costs over the usual and customary charge. 

5If the student's plan terminates before the 31 days from the date of birth, the newborn's coverage ends on the same termination date as that of the student.

6If services are rendered with a non-network provider, SHIP covers 100% of the usual and customary charge after a co-pay of $50. All costs over the usual and customary charge is the member’s responsibility.

Note: This page provides a summary of some benefits. Please see the Aetna Plan Design and Benefits Summary for plan details

Topics

SHIP Insurance topic page