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Medical Coverage for UC San Francisco

UCSF STUDENTS AND SPOUSES/DOMESTIC PARTNERS MUST START WITH THE SHCS FOR CARE TO BE COVERED BY UC SHIP

You must get an SHCS referral for care outside the SHCS, 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.

Other dependents should visit Anthem contracted providers for care.

Network
Out-of-Network
UC Family Providers Anthem Blue Cross Providers All Other Providers
  • SHCS
  • UC San Francisco Medical Center
  • Any other UC medical centers and their affiliated professional providers/facilities

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

Mental Health: $0

All other services: $200 individual/$400 family

Mental Health: $0

All other services: $750 individual/$1,500 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 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 Benefits and Coverage (SBC).

SHCS: 100% for primary care

UC Family

  • Primary care: 100% after $25 copay
  • Specialty care: 100% after $10 copay

Primary care: 100% after $25 copay, deductible waived

Specialty care: 100% after $40 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 SHCS: 100%
UC Family:  100% after $5 copay

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

65%, deductible waived
Inpatient hospital care UCSF Medical Center: 100%
All Other UC Family: 95%
90% after $250 copay 60% after $500 copay
Urgent care UC Family: 100% after $25 copay Network Providers and LiveHealth Online: 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