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Medical Coverage for UC Davis

ALL CARE MUST START WITH THE SHC TO BE COVERED BY UC SHIP.

You must get an SHC referral for care outside the SHC, regardless of the distance from campus, except for the following: emergency room care and visits to urgent care clinics, pediatric care, obstetrics services, gynecological care and LiveHealth Online virtual visits.

SHC
Outside the SHC
Your convenient, on-campus health home away from home for medical care

Network Providers
Providers and facilities in the Anthem Blue Cross Prudent Buyer PPO network including UC Family medical centers, physicians and affiliated facilities

Out-of-Network Providers
Any health care provider/facility you choose; however, you are responsible for paying any expenses above the Anthem Blue Cross maximum allowed amount.

Separate benefit-year deductibles
The amount you pay before UC SHIP pays for services

$0 $200 individual/$400 family

Separate limits on your out-of-pocket costs
If your medical and/or pharmacy expenses reach this amount, UC SHIP will pay 100% of your covered expenses for the rest of the plan year.

N/A

Network Providers: $2,500 individual/$5,000 family

Out-of-Network Providers: $6,000 individual/$12,000 family

Includes deductibles, coinsurance, medical copays and prescription copays
UC SHIP Covers

Office visits
Copay covers office visit only. Additional charges apply for other services, such as lab work. For details, see the Medical Summary of Benefits and Coverage (SBC).

100% Network Providers
  • 100% after $15 copay for primary care and specialty care, deductible waived
  • 100% after $15 copay for specialty care, deductible waived

Out-of-Network Providers: 60% for primary and specialty care

Routine physicals/student adult preventive care

100% Network Providers: 100%, deductible waived

Out-of-Network Providers: 60%

Mental health and substance use disorder office visits 100% Network Providers: 100% after $5 copay, deductible waived
LiveHealth Online: 100%, deductible waived

Out-of-Network Providers: 60%, no copay

Inpatient hospital care N/A Network Providers: 80%

Out-of-Network Providers: 60% after $500 copay

Urgent care 100% after $25 copay, deductible waived

Network Providers: 100% after $25 copay, deductible waived
LiveHealth Online: 100%, deductible waived
Out-of-Network Providers: 60%

Emergency care (non-admission) N/A Network Providers: 100% after $75 copay, deductible waived

Out-of-Network Providers: 100% after $75 copay, deductible waived

Copay waived if you are admitted.

Pediatric dental and vision care

Up to age 19

N/A

Dental checkup: 100%; basic and major services 50%

Network Vision Providers: Vision exam, frame (formulary) and standard lenses, and contact lenses covered at 100%

Out-of-Network Providers: Up to $30 allowance for exam, $45 for frame and $25 for lenses