Insurance

WELCOME TO THE UNIVERSITY OF CALIFORNIA STUDENT HEALTH INSURANCE PLAN (UC SHIP)

The University of California requires all students to have major medical health insurance as a non-academic condition of enrollment. All full and part-time undergraduate and graduate students with a USHIP/GSHIP fee assessed are automatically enrolled in, and charged for, the University of California Student Health Insurance Plan (UC SHIP). Students who demonstrate comparable health insurance coverage may submit an online request to waive out of UC SHIP.
Note: Once granted, the waiver is in effect for the current term and the remainder of the academic year. A new waiver request must be submitted at the beginning of each academic year
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Contents:
UC SHIP

- Medical Benefits
- Vision Benefits
- Dental Benefits

- Pharmacy Benefits
- Nurseline
Insurance Plan
- For Undergraduates
- For Graduates
- How to use SHIP

- Cost of UC SHIP
- Coverage Period

- UC SHIP Enrollment
- Voluntary Enrollment
- HEMBA/FEMBA

- First Summer SHIP

- Filing Fee
- Leave of Absence

- Dependent Plans
- Documentation

- After Graduation

Waiving UC SHIP
- On-line Waiver Info
- Waiver FAQ

Forms
Insurance FAQ(PDF)

   

Student Health Insurance Office Contact Information:

Phone: (949) 824-2388
Fax: (949) 824-5062

Address:
UC Irvine Student Health Center

Insurance Office
501 Student Health
Irvine, CA 92697-5200

 Regular Office Hours
Monday-Friday: 8:00 am-5:00pm

 

 

UC SHIP

The University of California Student Health Insurance Plan (UC SHIP) is a comprehensive major medical insurance plan, providing medical, behavioral health, prescription, dental and vision services.

The University of California Student Health Insurance Plan (UC SHIP) includes the following:

 

Medical Benefits (PDF)

The medical benefits of the plan are provided through Anthem Blue Cross. For more information please visit the Anthem Blue Cross web site at www.ucop.edu/ucship.

Customer Service: (866) 940-8306

Mental Health network of providers is Behavioral Health Network

Customer Service: (866) 940-8306

www.ucop.edu/ucship

 

Vision Benefits (PDF)

Your Vision benefits are provided through Anthem Blue Cross Blue View Vision. Vision care is not available on campus. However, there are many vision care providers available in the community. To find a provider, please click on this link.

Customer Service: (866) 940-8306

www.ucop.edu/ucship

 

Dental Benefits (PDF)

Delta Dental is the dental insurance provider for UC SHIP students. The Student Health Center Dental Clinic is staffed by Delta Dental PPO dentists and is conveniently located on campus. UC SHIP members can also select from a wide choice of local dentists, listed on the Delta Dental website at www.deltadentalins.com/ucship or www.ucop.edu/ucship.

Customer Service: (800) 765-6003

 

Pharmacy Benefits

 

Graduate (PDF)

Undergraduate (PDF)

 

Nurseline (PDF)

Toll-free number: (877) 351-3457

Available for all SHIP members when the Student Health Center is closed.

 

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Insurance Plan

 

University of California Student Health Plan for Undergraduates:

 

UC SHIP is a comprehensive health plan that provides medical, mental health, pharmacy, vision and dental coverage. It features year-round, world-wide coverage using the Anthem Blue Cross PPO network. The UC SHIP plan provides optimal coverage for services on campus and in the UC Irvine community, and peace of mind for both parents and students.

  • Effective fall quarter 2001 the Regents of the University of California instituted health insurance coverage as a condition of enrollment for all undergraduate students. This link will take you to details explaining the Regents decision www.ucop.edu. This insurance is included in your student fees and enrollment in the plan is automatic when you pay your fees. You may waive out of this plan if you can demonstrate comparable and verifiable health coverage that meets the campus' minimum standards for insurance.
  • The Student Health Center is the primary care facility for students covered by UC SHIP. In order to take advantage of your insurance plan, all medical care must begin at Student Health. If you need a medical service that we cannot provide, you will be referred to a qualified provider in the community. If you are a member of UC SHIP, the cost of your medical care will be billed directly to your insurance plan after collecting the copayment.
  • Students who waive out of the plan, but use Student Health Center services, will pay at the time of service and will be given an itemized receipt that the student may submit to their insurance carrier for reimbursement.

UC Irvine SHIP for Undergraduates Benefits Book (PDF)

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University of California Student Health Insurance Plan for Graduates:

 

University of California Student Health Insurance Plan for Graduates (UC SHIP for Graduates) is the University sponsored health insurance program for graduate students. Eligible graduate students are automatically enrolled in UC SHIP and the premium for this insurance is assessed each term on the graduate student's registration fee statement. You may request to waive out of this plan if you can demonstrate comparable and verifiable health coverage that meets the campus' minimum standards for insurance.

 

UC SHIP is a comprehensive health plan that provides medical, mental health care, pharmacy, vision and dental coverage. It features year-round, world-wide coverage using the Anthem Blue Cross PPO network. UC SHIP provides optimal coverage for services on campus and in the UC Irvine community, and peace of mind for both parents and students.

 

UC SHIP members receive their primary care at the Student Health Center, where treatment will be administered or, if necessary, a referral issued.

 

UC Irvine SHIP for Graduates Benefits Book (PDF)

 

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How to use UC SHIP

Here are the basics to get you started:

When you need health care:

With UC SHIP, all care must begin at Student Health Center (SHC). When you need medical care, there are three ways to make an appointment:

  • Online at www.shc.uci.edu
  • By telephone at (949) 824-5304
  • In person at the SHC Front Office

There are no claims to file for SHC visits.

Referrals from SHC clinicians

If necessary, the SHC physician will provide you with a referral for specialty care treatment that is not offered at the SHC. You must have outside appointments pre-authorized by the Insurance Office. Off-campus care (care outside of UCI SHC) is coordinated by SHC clinicians, and the Insurance Office staff will provide referrals for covered services and ensure that your claims are handled accurately.

For off-campus care, UC SHIP contracts with Anthem Blue Cross to provide medical and mental health services through their extensive network of hospitals and providers. If providers or facilities are used that are not part of the Anthem Blue Cross Prudent Buyer Provider Network, your claims will be paid at a percentage of the "limited fee schedule," which is often significantly lower than the network rate. To find an Anthem Blue Cross Prudent Buyer provider you can call the customer service number on the back of your health insurance card, or go to the Anthem Blue Cross web site at www.ucop.edu/ucship.

Emergency care

No referral/authorization from the Student Health Insurance Office is required for visits to an emergency room or urgent care center. Please provide facility with your Anthem Blue Cross card. Claims submitted to Anthem Blue Cross will be processed according to the UC SHIP benefits.

Students must return to the SHC for all follow-up treatment.

Pre-existing conditions

UC SHIP does not exclude pre-existing conditions. There is no waiting period for coverage for pre-existing conditions.

Authorization for Services

Most non-emergency services provided outside of SHC must receive prior authorization/referral or your claim may not be paid.

Services outside SHC that do not require pre-authorization/referral include:

  • Services provided in a hospital emergency room or urgent care center for treatment of a sudden, serious or acute injury, illness or condition
  • Prescriptions filled outside of SHC
  • Services provided under the dental coverage or vision services coverage.

Billing for services at SHC

At the time of service, patients will pay only the fees for which they are responsible, usually co-pay for office visit and pharmacy. SHC will then file a claim with Anthem Blue Cross for payment of the remainder of the covered charges.

Billing for services outside SHC

When students receive care outside of Student Health Center, the health care provider may require the co-payment at the time of service, or they may send a bill after Anthem Blue Cross has paid the covered amount. Most providers will submit bills directly to Anthem Blue Cross. If a student receives a bill for the full cost of services, the student should contact Anthem Blue Cross for assistance or seek guidance at the Student Health Insurance Office. For questions about claims or the Explanation of Benefits, call Anthem Blue Cross at 866-940-8306.

For out of state claims: when you are outside of California and receive health care services, you should request that your provider bill the local Blue Cross - Blue Shield company in that state to ensure your services are covered according to your UC SHIP benefits.


For out of country claims: be sure to obtain a bill that contains all of the information listed below. For convenience, you can print and use an "international claim form" from the BlueCard® Worldwide website.

To ensure proper payment or reimbursement of your claim, make sure you get an itemized bill from the provider. An itemized bill includes:

  • Provider’s name, address, and tax identification number. Individual providers must also include their professional license number.
  • Patient’s name, address, date of birth, and your insurance number.
  • Dates of service.
  • Procedure codes for service rendered.
  • Charges for each service.
  • Date of injury and description of how the injury occurred, if the claim is for treatment of an injury. This is especially important on claims for dental injury.

If any of this information is not included on a claim, the insurance payment may be delayed or denied. Most providers are aware of what is required for processing an insurance claim and will be happy to exchange an incomplete bill with one containing all of the required information.

Deductibles

There is a $200 plan year deductible for most services provided outside SHC. UC SHIP members are responsible for the first $200 of charges each plan year. Once the deductible has been satisfied, UC SHIP benefits begin. Services provided at SHC, prescription drugs, and outpatient psychotherapy are not subject to the $200.00 deductible.

Amounts over the "limited fee schedule" as determined by UC SHIP do not accumulate toward the deductible.

Dual coverage

Services provided at SHC will be billed exclusively to Anthem Blue Cross regardless of whether you have dual coverage through another plan in addition to UC SHIP. For services provided outside of SHC,
UC SHIP is secondary to all other insurance plans, (except Medi-Cal, TriCare, and MRMIP) meaning the other plan must pay for services first. In this case, UC SHIP will cover any charges, within the plan's benefit limits, not covered by your other plan. In order to coordinate coverage and payment, Anthem Blue Cross may ask you for information about your other plan.

Annual out-of-pocket maximum

Students are responsible for no more than $3,000 of out-of-pocket in-network expenses each plan year. If you have paid $3,000 in co-insurance (excluding deductible and copayments), you will no longer be required to pay co-insurance for the remainder of the plan year, but you remain responsible for co-payments and costs in excess of covered expense. The out-of-pocket maximum for out-of-network expenses is $6,000.

Lifetime maximum

UC SHIP has a $400,000 lifetime maximum.

Managing your plan

Updated address: It is very important that you keep your address updated. This is how UC SHIP knows your address. When you move or go away for the summer, please remember to update your address with the Office of the Registrar at http://www.reg.uci.edu/request/changeaddress.html.

 

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Cost of UC SHIP

 

UC SHIP Fees for 2012-2013 Academic Year

Includes: Medical, Behavioral Health, Vision & Dental

Per Term

Annual

Undergraduates

$924.00

Fall

$308.00

Winter

$308.00

Spring/Summer

$308.00

Graduates  

$2088.00

Fall

$696.00

Winter

$696.00

Spring/Summer

Medical - First Year, Transfer, Returning

Fall

Winter

Spring/Summer

Medical - Continuing

Fall

Winter

Spring/Summer

$696.00

$976.09

$696.00

$696.00

$696.00

$696.00

$696.00

$2368.09

 

$2088.00

Law - First Year, Transfer, Returning

$2328.08

Fall

$1284.08

Spring/Summer

$1044.00

         
Law - Continuing       $2088.00
Fall   $1044.00    
Spring   $1044.00    

 

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UC SHIP Coverage Period

UC SHIP Coverage Dates 2012-2013 Academic Year

Quarter

Begin

End

Medical Students (First Year, returning, transfer)

Fall 2012

08/06/12

01/01/13

Winter 2013

01/02/13

03/26/13

Spring 2013

03/27/13

09/22/13

Medical Students (2nd, 3rd, 4th Year)

Fall 2012

09/24/12

01/01/13

Winter 2013

01/02/13

03/26/13

Spring 2013

03/27/13

09/22/13

Graduate Students

Fall 2012

09/24/12

01/01/13

Winter 2013

01/02/13

03/26/13

Spring 2013

03/27/13

09/22/13

Law Students (New, transfer, returning)

Fall 2012

08/15/12

01/01/13

Law Students Continuing

Spring 2013

    Fall 2012

    Spring 2013

01/02/13

   09/24/12

   01/02/13

09/22/13

     01/01/13

     09/22/13

Undergraduate Students

Fall 2012

09/24/12

01/01/13

Winter 2013

01/02/13

03/26/13

Spring 2013

03/27/13

09/22/13

***Remember, if you have UC SHIP in spring term, you are covered through the summer until your fall term start date.

UC SHIP Enrollment

Who May Enroll

Students are automatically enrolled in the University of California Student Health Insurance Plan (UC SHIP), if charged a health insurance fee on their registration bill.

Eligibility for UC SHIP includes:

  • All registered undergraduate and graduate students of the Irvine campus at the University of California, including registered international students that are assessed the USHIP/GSHIP fee.
  • All graduate students who are registered-in-absentia.

 

How to Enroll

Eligible registered students are automatically enrolled in UC SHIP. The health insurance fee is billed as part of students' registration fees. Note: Students can request to waive enrollment with proof of comparable insurance and receive a refund for the UC SHIP fee. Waivers must be filed by the deadline date.

 

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Voluntary Enrollment

The following groups may purchase plan coverage through Wells Fargo Insurance Services at 800-853-5899.

 

EMBA | HCEMBA | FEMBA (Graduate students)

 

First Summer UC SHIP for Graduates

 

Approved Filing Fee Status (Graduate students)

  • All non-registered students on approved “Filing Fee Status” who are completing work under the auspices of the University of California, but are not attending classes. Filing Fee students are allowed to purchase UC SHIP for a maximum of one semester/quarter. The student must have been covered by the plan in the term immediately preceding the term the student wants to purchase, or, if the student waived enrollment in the prior coverage period, show proof of the plan used to waive. (PDF)

 

Approved Leave of Absence (Graduate students)

  • All non-registered students on approved “Leave of Absence”. These students are allowed to purchase UC SHIP for a maximum of one semester or two quarters. The student must have been covered by the plan in the term immediately preceding the term the student wants to purchase, or, if the student waived enrollment in the prior coverage period, show proof of the plan used to waive. (PDF)

 

Dependent Plans (Graduate and Undergraduate students)

  • Dependents of an enrolled student can enroll within the first 30 days of each coverage period during the plan year.

Dependent Enrollment

All graduate and undergraduate students who are enrolled in SHIP have the option to enroll eligible dependents in a voluntary plan. The plan provides medical insurance and the option to add dental and vision benefits. NOTE: If both student parents are covered by SHIP, their children may be covered as the dependents of either student, but not both.

Enrollment in the dependent plan is managed by Wells Fargo Insurance Services (on behalf of Anthem Blue Cross) and the cost of the dependent premiums is payable directly to Wells Fargo. For dependent plan enrollment questions, please call Wells Fargo Insurance Services customer services at 800-853-5899.

Links to Dependent Plan Benefits:

Enrollment Forms

Coverage of eligible dependents will not be effective prior to that of the insured student or extended beyond that of the insured student. Dependent enrollment or re-enrollment in the plan is not automatic. Eligible dependents must be re-enrolled in each subsequent term in order to continue coverage under the dependent plan.

 

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Documentation

Students are required to provide proof of dependent status when enrolling their dependents in the plan. The following documents are acceptable:

  • Spouse - marriage certificate
  • Same-Sex Domestic Partner - a Declaration of Domestic partnership issued by the State of California, or of same-sex legal union other than marriage formed in another jurisdiction, or a completed declaration of Domestic Partnership Form issued by the University
  • Natural Child - a birth certificate showing the student is the parent of the child
  • Stepchild - a birth certificate and a marriage certificate showing that one of the parents listed in the birth certificate is married to the student
  • Adopted or Foster Child - documentation from the placement agency showing that the student has the legal right to control the child's health care

 

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Health Insurance After Graduation (Graduate and Undergraduate)

Graduating students may purchase UC SHIP for one additional quarter/semester immediately following graduation if they were enrolled in the plan during their final academic term.

  • Graduate (PDF)
  • Undergraduate (PDF)

If you are an UC SHIP member who will be graduating this term, a variety of plans are available for you to purchase through Anthem Blue Cross once your UC SHIP coverage expires. Plan types include:

  • Short term coverage
  • Conversion plan – guaranteed issue for persons with ongoing medical conditions. (PDF)

Please visit Anthem Blue Cross website at: http://www.anthem.com/ca

 

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Waiving UC SHIP

All eligible graduate and undergraduate students at UC Irvine are automatically enrolled in UC SHIP and charged a health insurance fee as part of registration at UC Irvine.  If you are currently covered by major medical health insurance that is comparable to UC SHIP, you may request to waive out of the plan.

 

Wells Fargo Online Waiver

 

UC Irvine undergraduate students studying abroad through the Education Abroad Program are enrolled in a different insurance plan by EAP and are not eligible for UC SHIP during the quarters you are away. You should not complete this application for the quarters you are abroad.

 

To waive out of the UC Irvine sponsored health insurance plan for 2012-2013 you must submit a request on-line during the open waiver period in the table below.  If approved, the waiver is in effect for the current term and the remainder of the academic year. A new waiver request must be submitted at the beginning of each academic year.

 

Waiver Schedules for 2012-2013

Quarter

Begin

End

Fall

07/23/12

09/13/12

Winter

11/01/12

12/13/12

Spring/Summer

02/11/13

03/13/13

 

Semester

 

Begin

 

End

Fall

07/23/12

09/13/12

Spring

11/01/12

12/13/12

 

On-Line Waiver Information

 

Wells Fargo Online Waiver

 

IMPORTANT! You can submit the waiver request ONE TIME ONLY. Once the waiver has been submitted you will receive a “Waiver Accepted” or “Waiver Denied” response based on the answers provided on the waiver form. You will NOT be able to access the waiver system again to make any corrections, so it is important that you have all of the correct information in advance of submitting the waiver.

 

Please use the waiver worksheet to help gather your plan information and other requested information BEFORE you begin your online waiver application to complete all the questions quickly and accurately.

 

If you don't know the answers to the questions, please call the Member or Customer Service number on your insurance card for assistance. Most plan information can be found in your plan benefit booklet, benefits summary, or contract, or policy, or check online the health information to find the details of your plan. Incorrect answers could result in delay or denial of your waiver application. When you are ready to go on-line to waive, please remember to print a page of the waiver acceptance/denial page. The Insurance Office will not accept waiver requests past the posted deadlines and does not accept waiver requests in paper format.

 

Please submit your waiver application as soon as possible. If you wait until the last minute, you risk running into an overloaded computer system.

 

Your insurance coverage will be compared to UC SHIP guidelines and a waiver will be granted or denied based on the comparison.

 

If you submit a waiver request online, you will receive an instantaneous response. The last screen of the on-line waiver application process will provide you with approval or denial information. You should print this screen for your records. If your waiver has been approved, fees will be reversed and reflected on the student’s account within ten (10) business days.

 

You may also check your SHIP waiver status on Zot Account Online. (If you pay your fees before you have been notified that you have been granted a waiver, be sure you pay the entire fee amount. If you deduct the health insurance amount from the amount of fees you pay and your waiver request is denied, you risk having your classes dropped unless you pay the remainder of the fee before the registration fee deadline.)

 

Waiver FAQ (DOC)

If you want to waive participation in the Student Health Insurance Plan you must complete and submit an Online Waiver Application no later than 11:59 p.m. on September 13, 2012 for the FALL term, or no later than 11:59 p.m. on December 13, 2012 for the WINTER term, or no later than 11:59 p.m. on March 13, 2013 for the SPRING term.

The insurance policy covering the student must provide benefits comparable to the University’s guidelines. An “approved” confirmation notice or a “denied” statement is presented after you submit the waiver. You should print this notice for your records.

 

Yes. Your approved waiver is effective for the current academic term onlly. If you want to waive participation for the next academic year, you must file another waiver application.

 

Waiver applications may be completed and submitted online.

 

You will need information about your health insurance plan, including the company name and phone number, group number, the student’s policy identification number, the policy holder’s relationship to the student, and the summary of benefits.  Please use the waiver worksheet (PDF) to gather this information in advance of using the online waiver application.

 

You have two useful sources of information to help you complete your waiver application. First, you can refer to the Evidence of Coverage booklet. The booklet is provided by your insurance company and describes all of your benefits and the limitations of those benefits. If you cannot find your booklet, you may find it on the insurance company’s website or call the customer service number on your insurance card and ask for help.

 

If you submitted a waiver application online you will receive an instantaneous response. The last screen of the online waiver application process will provide you with approval or denial information. You should print this screen for your records.

 

If your waiver application is denied because your private insurance benefits are not sufficient, you may appeal the denial by submitting an “Appeal of Waiver Denial” form, which you can download here and which is also available at the Student Health Center Web Site at www.shc.uci.edu. Completed appeal applications must be received within ten (10) calendar days from the date of denial. Appeals for denied waiver applications are accepted only for the current term. Retroactive appeals are not accepted. Incomplete appeal applications will not be considered for review.

 

You are required to maintain comparable health insurance at all times during your approved waiver period. If your health insurance coverage is terminated during the waiver period, you are required to enroll in the Student Health Plan. To enroll in the plan you must submit a Waiver Reversal Form to the UC Irvine Insurance Office immediately. UC Irvine Student Health Plan coverage will be effective in the term specified on the form. Your student account will be billed.

 

 

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Forms

Dependent Eligibility & Documentation (PDF)

 

SHIP Waiver Appeal Denial Form

If your waiver application has been denied due to inaccurate or incomplete information, you may complete the Waiver Appeal Form and submit, including supporting documents to the SHC Insurance Office within 10 business days of your waiver denial.

 

SHIP Waiver Reversal Form

If you have waived SHIP enrollment and wish to reverse your waiver, you can fill out a Waiver Reversal Form and submit the completed form to SHC Insurance Office during the enrollment period.

 

Also, if you lose your private insurance between terms, you can purchase SHIP at the full cost of the term. An official Letter of Termination/Loss of Coverage from your previous health insurance carrier must be submitted to the SHC Insurance Office to initiate the enrollment process. Your effective date of coverage will be the day following completion of the waiver reversal form and documentation of your loss of coverage.

 

Student Health Center Insurance Office Contact Information:

Phone: (949) 824-2388
Fax: (949) 824-5062

Address:
UC Irvine Student Health Insurance Office
501 Student Health
Irvine, CA 92697-5200

Regular Office Hours
Monday-Friday: 8:00 am-5:00pm

 

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