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Medical Coverage for UC Merced

SHC
Outside the SHC
  • Your convenient, on-campus health home away from home

Network Providers

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

Out-of-Network Providers

  • Any other health care provider/facility you choose; however, you are responsible for paying any expenses above the Anthem Blue Cross maximum allowed amount.

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: $3,000 individual/$6,000 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, deductible waived
  • 100% after $20 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 N/A Network Providers: 100% after $15 copay, deductible waived
LiveHealth Online: 100% after $15 copay, deductible waived

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

Inpatient hospital care N/A Network Providers: 90%

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

Urgent care N/A Network Providers: 100% after $50 copay, deductible waived
LiveHealth Online: 100% after $15 copay, deductible waived

Out-of-Network Providers: 60%

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

Out-of-Network Providers: $100 copay

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%

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