Waiver Criteria

SHCS Service Announcement

Due to scheduled union action on

Tuesday, April 1st,

there may be a reduction in services at SHCS.

We are taking necessary precautions to assure your visit to SHCS during that timeframe goes smoothly.

Anytime, including when SHCS has reduced services, students can call the following resources:

Medical:

Medical Advice Nurse at 530-752-2349

Counseling:

Counseling Services 24 Hour Consultation Line: 530-752-0871 or

Suicide & Crisis Lifeline: at 988

Additional support is available: LiveHealth Online for SHIP students (virtual medical and mental health care) and UWill (virtual mental health care).

In order to qualify for a waiver of the automatic enrollment in UC SHIP, students must have insurance coverage that meets or exceeds all of the below criteria.

Please review the below criteria as it has changed from prior years.

If you have any questions regarding the UC SHIP waiver criteria listed below, please email Insurance Services at waiver@shcs.ucdavis.edu, or stop by the Insurance Services office at the Student Health and Wellness Center.

**Travel plans, Ministry cost sharing plans, and county medical service plans (CMSP) are not allowed to be used to waive enrollment in UC SHIP**

Waiver Criteria - Domestic Students

All plans must provide unrestricted access to an in-person, in-network primary care provider, in-network hospital, and full, non-emergency medical and behavioral health care within 175 miles of campus or the student's place of residence while attending school.
Coverage is currently active and the student agrees to maintain health coverage throughout the entire academic year. If your current insurance is terminated, contact the Insurance Services office as quickly as possible to discuss your health insurance options.
Your plan must be a Medi-Cal/Medicaid, Medicare, TRICARE/Military, Covered California or other U.S. federal or state exchange plan, a UC Employee health plan, OR
An employer-sponsored group health plan or individual plan that must cover the following:
a) An annual out of pocket maximum of no more than $9,450 for an individual, or no more than $18,900 for a family plan. The annual out of pocket maximum can exceed these dollar amounts if your plan has a Health Savings Account or a Health Reimbursement Account.
b) Covers inpatient (hospital) and outpatient care for mental health and substance abuse disorder conditions the same as any other medical condition.
c) Doctor office visits for medical, including mental health, and alcohol/drug abuse conditions
d) Provides coverage for all Minimum Essential Health Benefits. For the criteria, please see: https://www.cms.gov/cciio/resources/data-resources/ehb.html
e) May not be a health care or pharmacy reimbursement plan (A reimbursement plan means the student must pay for services and seek reimbursement from the insurance provider)
f) Have no per medical or mental health/substance abuse dollar maximums limits

Waiver Criteria- International Students

All plans must provide unrestricted access to an in-network primary care provider, in-network hospital, and full, non-emergency medical and behavioral health care within 175 miles of campus or the student's place of residence while attending school.
Coverage is currently active and the student agrees to maintain health coverage throughout the entire academic year. If your current insurance is terminated, contact the Insurance Services office as quickly as possible to discuss your health insurance options.
Your plan must be a Medi-Cal/Medicaid, Medicare, TRICARE/Military, Covered California or other U.S. federal or state exchange plan, a UC Employee health plan, OR
An employer-sponsored group health plan or individual plan that must cover the following:
a) An annual out of pocket maximum of no more than $9,450 for an individual, or no more than $18,900 for a family plan. The annual out of pocket maximum can exceed these dollar amounts if your plan has a Health Savings Account or a Health Reimbursement Account.
b) Covers inpatient (hospital) and outpatient care for mental health and substance abuse disorder conditions the same as any other medical condition.
c) Doctor office visits for medical, including mental health, and alcohol/drug abuse conditions
d) Provides coverage for all Minimum Essential Health Benefits. For the criteria, please see: https://www.cms.gov/cciio/resources/data-resources/ehb.html
e) May not be a health care or pharmacy reimbursement plan (A reimbursement plan means the student must pay for services and seek reimbursement from the insurance provider)
f) Have no per medical or mental health/substance abuse dollar maximums limits
Cover services related to suicidal conditions, including attempted suicide or suicidal thoughts
Cover medical services for injury from participation in all types of recreational activities or amateur sports
Have no pre-existing condition exclusion or limitation; if the plan has a pre-existing condition waiting period, that period has expired
Have no lifetime maximums on benefits
Have a complete master policy written in standard English with benefits expressed in U.S. dollars
Have a claims payment office with an address and phone number in the United States
Pay at least $50,000 annually for medical evacuation
Pay at least $25,000 for repatriation of remains