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Medical Coverage for UC Hastings

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, vision care, dental care and LiveHealth Online virtual visits.

During summer months and breaks when the SHC is closed, you can visit an Anthem Blue Cross primary care clinician without a referral. However, be sure to get a referral from your primary care clinician in the Anthem Blue Cross Prudent Buyer PPO network if you need to see a specialist.

Network
Out-of-Network
UC Family Providers Anthem Blue Cross Providers All Other Providers
  • SHC
  • UCSF Medical Center
  • Any other UC medical centers and their affiliated facilities and professional providers
Providers and facilities in the Anthem Blue Cross Prudent Buyer PPO network 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

SHC lab services: $200 individual/$400 family (combined with the in-network deductible)

Other care and services: $0

$200 individual/$400 family $500 individual/$1,000 family
Separate annual 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.

$2,000 individual/$4,000 family $3,000 individual/$6,000 family $6,000 individual/$12,000 family
Includes deductibles, coinsurance, medical copays and pharmacy 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).

SHC: 100% for primary and specialty care

UC Family

  • Primary care: 100% after $5 copay
  • Specialty care: 100% after $10 copay
  • Primary care: 100% after $20 copay, deductible waived
  • Specialty care: 100% after $40 copay, deductible waived
  • LiveHealth Online: 100% after $20 copay, deductible waived
60% for primary and specialty care
Routine physicals/student adult preventive care 100% 100%, deductible waived Not covered
Mental health and substance use disorder office visits SHC: 100%
UC Family: 100% after $5 copay

Network Providers and LiveHealth Online: 100% after $15 copay, deductible waived

60%, no copay
Inpatient hospital care UC Family: 90% 90% after $500 copay 60% after $500 copay
Urgent care UC Family: 100% after $25 copay 100% after $25 copay, deductible waived 60%
Emergency care (non-admission) 100% after $125 copay 100% after $125 copay, deductible waived

100% after $125 copay, deductible waived

Pediatric dental and vision care

Up to age 19

N/A

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

Vision exam, frame (formulary) and standard lenses, and contact lenses: 100%

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

Vision: up to $30 allowance for exam, $45 for frame and $25 for lenses