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Medical Coverage for UC Los Angeles

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

You must get an SHC referral for care outside The Ashe Center, 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.

Network
Out-of-Network
UC Family Providers Anthem Blue Cross Providers All Other Providers
  • The Ashe Center
  • The Ronald Regan UCLA Medical Center
  • The Santa Monica Medical Center
  • The UCLA Counseling & Psychological Services
  • Any other UC medical centers and their affiliated facilities and professional providers 
Providers/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

$0 $300 individual/$600 family $500 individual/$1,000 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.

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

The Ashe Center: 100% for primary and specialty care
UC Family
  • Primary care: 100% after $10 copay
  • Specialty care: 100% after $15 copay

Network Providers

  • 100% after $25 copay for primary care, deductible waived 
  • 100% after $40 copay for specialty care, deductible waived 

LiveHealth Online: 100% after $10 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 At CAPS, the UCLA Campus Counseling Center: 100%

Visit www.counseling.ucla.eduor call (310) 825-0768

UC Family: $10 copay

100% after $10 copay, deductible waived

LiveHealth Online: 100% after $10 copay, deductible waived

60%, no copay
Out-of-country behavioral health office visits N/A Office visit $10 copay, deductible waived
60%
Psychiatric care with CAPS referral

At UCLA Neuropsychiatric Behavioral Health Sciences (NPBHS): 100%

UC Family: $10 copay

100% after $10 copay, deductible waived 60%
Inpatient hospital care UC Family: 90% 80% after $250 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%

VisionUp to $30 allowance for exam, $45 for frame and $25 for lenses