American Healthcare 101 Workshop. Spring 2018
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- Bryce Powers
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1 American Healthcare 101 Workshop Spring 2018
2 American Healthcare In the United States healthcare consists of three areas. Healthcare Facilities Health Insurance Healthcare Providers
3 Health Insurance A contract to pay for medical services covered by your health insurance plan American health insurance is not automatic You must enroll in a health insurance plan in order to be covered to see a doctor
4 InsuranceRequirement All registered UC students are required to have a major medical health insurance plan Automatic enrollment in Berkeley SHIP when registered Annual online waiver program Can reverse waiver if other coverage is lost Can maintain dual coverage
5 Cost of SHIP SHIP is a comprehensive plan that covers medical, mental health, dental and vision services, plus a 24/7 nurseline. Fall Semester: August 1 thru December 31 Spring Semester: January 1 thru July 31 Charged Per Semester Total Annual Cost Undergrads $1,415 $2,830 Grads $2,231 $4,462
6 Plan Carriers Medical and mental health plan through Anthem Blue Cross Dental plan through MetLife Vision plan through Vision Service Plan (VSP)
7 Great Plan Benefits Primary and Urgent Care Prescription Drug Coverage Mental Health Care Preventative Services Physical Therapy Maternity
8 All Medical Care Starts at Tang Authorizations/Referrals University Health Services manages the medical & mental health care of registered students with SHIP All registered students can use Tang even if not on SHIP Except for emergency or urgent care and limited women s health services, authorizations are required for ALL services received outside the Tang Center
9 What services require authorization? medical services of the Tang Center
10 Definitions Premium The amount you pay to be enrolled in insurance plan Undergrad premium is $1,415/semester Grad premium is $2,231/ semester Co-insurance The percentage of the health care costs you have to pay. EXAMPLE: For some services, Berkeley SHIP pays 90%, and you pay 10% Deductible The amount of medical costs you have to pay before your insurance kicks in per year. EXAMPLE: Berkeley SHIP has a $300 annual deductible for some services outside of Tang Co-pay An upfront cost you pay when you have an office visit; Not counted as part of deductibles. EXAMPLE: Primary Care visits at Tang are $15 WHAT INSURANCE COMPANY PAYS: Balance after you meet the deductible and pay co-insurance or co-payment for each service
11 Mental Health Care Student sees mental health care provider in the Tang Center (first 5 visits are free of charge) When necessary, an authorization for continued mental health care outside Tang Center is granted and names of network providers are provided to student (no limits apply) Student pays $15 co-pay (deductible waived), Anthem pays the rest (applies to in network providers)
12 Insurance Cards Mailed to local address Download and print online mobilehealthconsumer.com/studenth ealth Student Health App for smart phones No other insurance cards needed!
13 Where do I go?
14 Tang Center is located. Tang Center 2222 Bancroft Way Berkeley, CA at Bancroft and Fulton
15 Making Appointments Call (510) Come to the Tang Center Appointment Office etang.berkeley.edu
16 VSP Vision Plan Eye exam $10 copay, once every 12 months Frames and lenses OR contact lenses $25 copay, once every 12 months, up to a $150 value Lens Options 20% discount on lens options such as Transitions lenses, antireflective or anti-scratch coatings, UV protection, and others Lasik or PRK Refractive Surgeries 15% discount
17 Vision: where to go Minor Hall Tang Center Phone: (510) Office Hours: Monday-Friday 8:00 am - 11:45 am 12:45 pm - 4:45 pm Phone: (510) Clinic Hours: M-F 8:30am - 5:30pm SAT & SUN 8:30am - 3:30pm
18 MetLife Dental MetLife Network More than 100 dentists within a 5 mile radius of campus. Benefit limits Covers up to $2,000 per plan year for all dental benefits Preventative & Diagnostic Services (pays 100% of negotiated fees, no deductible) oral exams, cleanings, fluoride treatment once every 6months X-ray Bitewing (once each 24 months) X-ray Full mouth (once every 5 years) Basic Services (Pays 80% of negotiated fees after $25 annual deductible) Fillings & extractions Endodontics (root canal), Periodontics & Oral Surgery Major Services (Pays 70% of negotiated fees after $25 annual deductible) Prosthodontics, In-Lays/On-Lays, Crowns & cast restorations
19 I don t have SHIP. What happens to me? registered students can use the Tang Center, even if they don t have SHIP You will pay the for services that have costs at the Tang Center The Tang Center is not contracted with any outside insurance plans The Tang Center does not bill any outside insurances
20 We are here to help! Website: uhs.berkeley.edu/ship us: or send a message through etang secure portal: etang.berkeley.edu Call us: (510) Visit us: 3 rd Floor of the Tang Center 2222 Bancroft Way Room 3200 Berkeley, CA
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