UC SHIP: A Guide for Students and Parents

There is no out-of-pocket cost to students covered by UC SHIP for the COVID-19 and other required vaccines as these services are considered "preventative care". If a student receives a vaccination at an off-campus clinic, then they must obtain a referral from SHC's Insurance Services Department in order for the vaccine provider to be reimbursed by Anthem (UC SHIP's carrier). To request a referral prior to being vaccinated or to request a retroactive referral after being vaccinated:

Please note that all communications with SHC's Insurance Services department regarding referrals must be submitted via the Student Health Patient Portal in order to ensure confidentiality, privacy and security of your protected health information (PHI) and/or personally identifiable information (PII). To request a referral prior to being vaccinated or to request a retroactive referral after being vaccinated, please submit a request via the Student Health Patient Portal:

• On the portal homepage, Go to "Messages"
• Select "New Message" 
• Select "SHC - Insurance: Referral Request and Other General Inquiries"

To send documents securely to Insurance Services, please upload the document(s) on the Student Health Patient Portal:

• Go to "Clearances/Uploads"
• Select "SHC Insurance Department"

Note that, if the vaccine is received at a retail pharmacy, then a referral from SHC is not required. 

In accordance with CDC/CMS guidance, vaccine providers may not bill patients directly either for the vaccines or for vaccine administration fees. If students receive the vaccine(s) and subsequently receive a notice from their vaccine provider requesting additional information due to the claim being denied by Anthem, then they should immediately contact the Insurance Services Department at UCI Student Health Center to request that a retroactive referral be faxed to the provider's office and/or billing department as soon as possible. Students should also contact the provider's office and/or billing department immediately upon receiving a bill to advise them that a retroactive referral will be requested. The provider can then resubmit the claim to Anthem with the referral and be reimbursed accordingly.

For more information on UC SHIP Dates of Coverage, please visit https://shc.uci.edu/insurance/uc-ship-benefits-and-information/cost-ship. For students who wish to waive UC SHIP, please visit SHC’s website here for detailed information >>> Waiving UC SHIP. As is always the case, a waiver will only be approved if the student can demonstrate that the health insurance plan with which they are waiving complies with UC’s waiver criteria. Please note that separate waiver periods are established for programs that start during the Summer and/or "early start" programs such as School of Medicine and School of Law.

Yes. UC SHIP coverage remains in effect for the entire academic year and regardless of the student's location during breaks, their residence, etc...

As a reminder, UC SHIP is a comprehensive health insurance plan that includes medical, mental health, dental, vision and pharmacy benefits. The plan features 24/7, year-round, world-wide coverage utilizing the Anthem Blue Cross Prudent Buyer PPO network.

For AY 2023-24, the corresponding UC SHIP coverage begins 9-18-2023 for the vast majority of incoming students who are on the quarter system. “Early start” graduate programs (e.g., School of Law, School of Medicine, MSBA) have varying coverage start dates depending upon the start date of their respective programs. The 9-18-2023 coverage start date is one week prior to the start of the Fall 2023 term. This "extended" coverage was approved by campus leadership in order to provide health insurance coverage for students who must arrive on campus prior to the official academic term start date (i.e., 9-25-2023) to attend mandatory orientations and events including housing related activities. However, The 9-18-2023 coverage start date applies regardless of the student's place of residence and mode of academic instruction during the Fall 2023 term.

Yes. There are currently several telehealth options for students that are covered benefits under the UC SHIP plan:

Option #1:

Primary Care and Psychiatry telephone and video consultations with a SHC primary care provider or psychiatrist are available at UCI Student Health Center by appointment. Certain types of conditions or procedures may require an in-office appointment as determined by the provider. SHC-based teleheath encounters are currently covered by UC SHIP. Please be advised that telehealth visits with students who are currently residing outside of California could be suspended pending guidance from the University's health care legal counsel in light of the differences in regulations among the states related to the provision of health care across state lines.

Check the SHC website regularly for updates and/or call the SHC appointment line at 949-824-5304 for information and/or to schedule a telehealth appointment.

Also, please check the Counseling Center website for information regarding telehealth counseling and behavioral health services that are available from the Counseling Center.

Option #2:

Another telehealth option for students for primary care and mental health care services is Anthem’s telehealth platform known as LiveHealth Online (LHO). LHO enables the student to video chat with board certified physicians, psychiatrists and counselors for conditions such as:

• Rashes, minor cuts and scrapes
• Stress, anxiety and other mental health concerns
• Coughs, colds, and other symptoms associated with mild respiratory infections
• And much more

The co-pay for a LHO primary care or mental health consultation for UC SHIP enrolled students is $10.00. Visit https://shc.uci.edu/services/livehealth-online for more information. Follow the link to sign-up and use LiveHealth Online.

Option #3:

Our partners at UCI Health offer a telemedicine option, UCI Health OnCall, which gives you convenient access to a board-certified U.S. primary care physician 24 hours a day, 7 days a week by telephone, video or mobile app. You can talk to a doctor at any time, from wherever you are. For details, visit here.

A:  To find providers that are in the Anthem network within the surrounding community of UCI or near your current place of residence, please utilize the following resources:

• Visit the Anthem website at https://www.anthem.com/find-doctor/ and search for a provider within your zip code.
  • Choose to search as a guest or by entering your Anthem member ID
  • Under “What type of care are you searching for?” Select Medical
  • Under “What state do you want to search in?” Select California
  • Under “What type of plan do you want to search with?” Select Medical (Student Health)
  • Under “Select a plan/network” Select UCSHIP PPO
  • Click Continue
  • On the following page, please select the details of provider specialty or provider type such as an urgent care, hospital or other types of providers and location for which you would like to search.

You can also call Anthem directly at 1-866-940-8306 and ask a representative to generate a list of network providers in your local area and send to you via email.

A: For students enrolled in UC SHIP, Student Health Center is your primary care provider. All care must begin at SHC. For services not provided at SHC, your SHC primary care provider would generate a referral to a community provider. Referrals to off-campus providers require an appointment with your SHC primary care provider first unless the student is located beyond fifty (50) miles from campus at the time of the request and/or is approved for remote learning. Exceptions: Referrals for off-campus behavioral health services  and chiropractic/podiatry/acupuncture services do not require that you visit a SHC provider first. Referrals to off-campus primary care providers are rarely approved; only for special circumstances; and require an appointment with a SHC primary care provider first before the referral will be considered.

For questions and additional information and/or to request a referral, please note that all communications with SHC's Insurance Services department regarding this type of request must be submitted via the Student Health Patient Portal in order to ensure confidentiality, privacy and security of your protected health information (PHI) and/or personally identifiable information (PII). Please submit a request via the Student Health Patient Portal and include the same information listed in the question and answer immediately preceding this question.

• On the portal homepage, Go to "Messages"
• Select "New Message" 
• Select "SHC - Insurance: Referral Request and Other General Inquiries"

The referral will be fax’d immediately to the designated community provider.

To send documents securely to Insurance Services, please upload the document(s) on the Student Health Patient Portal:

• Go to "Clearances/Uploads"
• Select "SHC Insurance Department"

A:  To obtain a referral, you need to provide:

• Your Student ID Number
• Specialty (e.g., Dermatology, Cardiology, Psychiatry, etc…)
• Reason for Visit (e.g., Acne, Anxiety, etc…)
• Name/Address/Telephone #/Fax # of the Provider/Clinic

A: For special circumstances and on an exception basis, SHC may approve referrals to an off-campus primary care provider. In general, the student must be located beyond fifty (50) miles from campus or approved for remote learning. Otherwise, the student must visit a SHC primary care provider first to discuss the reason(s) for the special request.

Please note that all communications with SHC's Insurance Services department regarding this type of request must be submitted via the Student Health Patient Portal in order to ensure confidentiality, privacy and security of your protected health information (PHI) and/or personally identifiable information (PII). Please submit a request via the Student Health Patient Portal and include the same information listed in the question and answer immediately preceding this question.

• On the portal homepage, Go to "Messages"
• Select "New Message" 
• Select "SHC - Insurance: Referral Request and Other General Inquiries"

To send documents securely to Insurance Services, please upload the document(s) on the Student Health Patient Portal:

• Go to "Clearances/Uploads"
• Select "SHC Insurance Department"

Yes. The following medical services DO NOT require a referral from Student Health Center:

• Hospital Emergency Room
• Urgent Care
• Pharmacy services
• Obstetrical or gynecological care
• Dental services
• Optometric (Vision) services
• Pediatric services​
• Services received during Winter Break

Yes. Note that referrals to continue care with an off-campus provider must be renewed at the start of each new plan year which coincides with the start of the Fall term.

Please note that all communications with SHC's Insurance Services department regarding this type of request must be submitted via the Student Health Patient Portal in order to ensure confidentiality, privacy and security of your protected health information (PHI) and/or personally identifiable information (PII). Please submit a request via the Student Health Patient Portal by sending a message to include the new provider information so that your referral can be updated and fax’d to the new provider. 

• On the portal homepage, Go to "Messages"
• Select "New Message" 
• Select "SHC - Insurance: Referral Request and Other General Inquiries"

To send documents securely to Insurance Services, please upload the document(s) on the Student Health Patient Portal:

• Go to "Clearances/Uploads"
• Select "SHC Insurance Department"

There may be a co-insurance applied under UC SHIP for medically necessary screening, testing and treatment for COVID-19. Cost sharing includes, but is not limited to, copays, deductibles or coinsurance. Medically necessary screening, testing and treatment for COVID-19 may include hospital services (including emergency department), urgent care visits, provider office visits,telehealth encounters (e.g., LiveHealth Online) and clinical labs where the purpose of the visit is to be screened, tested and/or treated for COVID-19.

Administrative testing (e.g. travel clearance, work clearance, etc.) for COVID-19 is not covered by UC SHIP.  This is very similar to testing required for SCUBA certifications, DMV commercial driver’s license certifications, work-related clearances, etc... In these scenarios, testing is a function of the activity the patient has electively decided to participate in, and is unrelated to their medical care.

Medically necessary screening, testing and treatment are covered services under UC SHIP. The CARES Act and Governor Newsom’s Executive order at the onset of the COVID-19 pandemic require federal or CA insurance plans to cover all medically necessary testing for COVID-19.  The majority of cases that meet “medically necessary” criteria (as determined by their evaluating clinician) will be symptomatic patients.

There are, however, asymptomatic patients in which testing might be determined to be medically necessary. For instance, there are a range of scenarios where COVID-19 testing of an asymptomatic patient would be clinically indicated, such as prior to surgery with an anticipated prolonged intubation or a bone-marrow transplant; prior to initiating therapy with an immune-modulating agent or chemotherapy, prior to a resident returning to a nursing home, etc.  

In addition, the CDC also recommends that asymptomatic people who meet the CDC definition of having “close contact” with a diagnosed case of COVID-19 should also be tested, and this makes the case for being medically necessary, due to meeting both of those conditions.  

The CARES Act and Governor Newsom’s order do not, however, state that all asymptomatic testing must be covered.  Many organizations, businesses, and universities have decided to move forward with a variety of screening and testing programs, though these are not typically done through individual’s insurance plans, but by the businesses themselves. Many universities are also developing or already conducting research protocols around COVID-19 testing, including several UC campuses.  Research activity is not typically covered by medical insurance plans, but by research funding.  In addition, public health surveillance testing is not typically covered by insurance, but by public health funds.  CDC and CDPH may issue additional guidance in the future for Institutions of Higher Education so these criteria are subject to change.

Students will be financially responsible for any COVID-19 related services that are deemed to be NOT medically necessary. For a schedule of fees for the most common services provided by SHC including COVID-19 testing, please visit Fees for Most Common Services.  

For detailed benefits and cost share information (i.e., office visit copays, coinsurance percentages and out-of-pocket maximums) related to all UC SHIP benefits, please visit the SHC's "USHIP Benefits" webpage here (the plan benefits are the same for both undergraduate and graduate plans).  

A: Yes, the SHC Dental Clinic is open and is offering its full array of routine, restorative care, specialty care and emergency dental procedures. Check SHC’s website regularly for updates. To find a dentist or dental specialist near your home, visit the Delta Dental website: Delta Dental. Dental services do not require a referral.

A: To find an Anthem Blue View Vision optometrist or other optical services provider near your current place of residence, visit https://www.anthem.com/ca/  or call Anthem Customer Care at (866) 940-8306. For benefits , click here >>> Blue View Vision Benefits. Please note that UCI's Gavin Herbert Eye Institute, Orange County's premier eye care provider located on the Health Sciences campus, offers state-of-the-art ophthalmic services, ranging from routine ophthalmic evaluations to complex medical management and surgical care. Its faculty of internationally recognized physicians, surgeons and scientists provide highly specialized training to future ophthalmologists, access to leading-edge clinical trials as well as sight-saving treatments and therapies for virtually any eye disorder.

A:  Download the Anthem-Sydney Health app flier for instructions on how to get your medical ID card. You will need to show your Anthem Blue Cross (Anthem) ID card when you get care or prescriptions outside of the SHC. Go to the App Store or to Google play to download the Anthem-Sydney Health app. Hard copy ID cards are not automatically mailed to students.

A:  Yes. The UCI Student Health Center and the Student Health Services at the other UC campuses all offer reciprocal access to care to currently registered students under the same conditions that apply to its own students. If you visit an SHS at another campus, you may need to pay out-of-pocket and be reimbursed for any services you receive if that SHS does not participate in the UC Student Health Insurance Plan (UC SHIP). Please check the SHS website of the UC campus you plan to visit for more information about fees, filing claims to UC SHIP, etc...  You should call or email the SHS first to see what services are available on-site or remotely during this time in which either full or partial campus closures may be in effect.

If you are visiting the UCI Student Health Center from another campus, you will not have to pay the fees at the time of service. SHC will bill your UC SHIP plan and then you will be billed for any copay or coinsurance amounts that you may owe. However, as noted above, if your home campus does not participate in UC SHIP, then you will be responsible for payment of all fees at the time of service.

A:  For students who are using Student Health Center Pharmacy for their medications but will be out of the area and/or "distance-learning" during the Summer, upcoming Fall term and/or subsequent terms, please consider the following:

• UCI Student Health Center Pharmacy offers medication delivery by mail. Unfortunately, we can only deliver to addresses within the state of California.
• To utilize this service for new prescriptions and/or medication refills, please communicate with our pharmacy via our Online Prescription Request page to request a non-urgent new prescription or additional medication supply. Please allow up to three business days for the pharmacy to prepare and mail your prescriptions.  Please note that we will do our best to assist you with your request. However, refills that require a provider’s authorization will still apply and may take longer. 
• If you have internet access issues and cannot request a new medication or refill online, please contact the SHC Pharmacy at 949-824-5923 and leave a voice message. Please provide the following information:
  • Your name, date of birth, and student ID.
  • Prescription Number (for refills) and/or name of medication.
  • Indicate if you would like the medication(s) delivered by mail and, if so, please provide your current shipping address and telephone number.
  • Additional comments, if any.
• The pharmacy staff will advise you regarding the amount of medication that can be dispensed based upon the current, active prescription on file and UC SHIP pharmacy benefits.
• To access the Online Prescription Request page, please follow the instructions below if you are not familiar with the process.

1. From the SHC website homepage at www.shc.uci.edu, click on the “Student Health Patient Portal” link.
2. Login using your UCINetID.
3. Click on "Pharmacy" just below the "Student Health Quick Links" header on the portal homepage.
4. Click on “New Message".
5. Click on “I would like to send a secure message to the Student Health Center”.
6. Click “New Prescription or Refill Request”.
7. Before proceeding, it is very important that you indicate that you wish to have the medication(s) delivered by mail and you must also include your current shipping address and telephone number.
8. Continue to fill in appropriate text boxes as accurately and completely as possible. Your Rx-number is located on your prescription label on the medication bottle in the yellow bar right above your name.
9. If you are unsure, please add a comment under the “Comment” section.
10. Click “send”.

• Please note that certain types of medications do not qualify for this mode of delivery per DEA and State Pharmacy regulations (i.e., controlled substances). An in-person pickup from a pharmacy is still required for these medications. 
• If you are living on, near or within close proximity to campus, there should be no change for you. Our UCI SHC Pharmacy will continue to operate under normal business hours contingent upon directives and guidance from the University. For the most up-to-date information, please visit our website regularly at www.shc.uci.edu.

A:  Please check the SHS website of the campus that is near your home and then call or email that SHS campus pharmacy to inquire if they are able to refill your medications for you. You should be ready to provide the name of your home campus, your UC SHIP ID number, and information on the prescriptions you need to have refilled. Co-pay amounts may vary from those you typically pay at your home campus SHS pharmacy.

A:  Yes, in most cases. OptumRx administers the pharmacy benefit for UC SHIP and has a nationwide network of retail pharmacies (e.g., CVS, Walgreens, etc..). Contact your local pharmacy with your prescription and your Anthem medical ID card to see if they are in-network and able to refill your medications for you. Retail pharmacies are able to refill prescriptions with a 30-day supply of medications. Co-pays may vary from those you typically pay at your campus SHC pharmacy.

A:  Yes, if in a clinical setting. No, if at a retail pharmacy within the Optum Rx network. Note that a CVS "Minute Clinic" is actually a clinic and not a pharmacy provider. Therefore, a referral would be needed. Retroactive referrals will be readily provided by SHC if you did not obtain a referral prior to receiving your vaccination(s). To request a referral, please submit your request securely via the Student Health Patient Portal (Go to: Messages -> New Message -> SHC – Insurance: Referral Request and Other General Inquiries).