UC Santa Cruz Student Health Center. Beth Hyde, NP Family Nurse Practitioner Patient Care Coordinator
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- Philomena Bailey
- 8 years ago
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2 UC Santa Cruz Student Health Center Beth Hyde, NP Family Nurse Practitioner Patient Care Coordinator
3 Nutritionist Physicians Nurse Practitioners and Physician Assistants Psychiatry Student Health Center Optometry Counseling Laboratory Pharmacy X-ray
4 Counseling and Psychological Services hour Access Number Daytime: Front Office Nighttime: Crisis worker on line Short term therapy Groups Referrals and Case management
5 Psychiatric Services Combination of on-campus and community service providers Plan Now for Transitions! Call and speak to a case manager For Students with ADHD Follow the specific Instructions on our website:
6 Health Center Appointments Mostly Same Day On-line Scheduling Preventive and Illness care Women s Health Travel Clinic Allergy Shots Dietitian
7 Medical Care Outside the Student Health Center Call 911 for emergency Paramedics/Fire Department on campus 24/7 Dominican Hospital is our local hospital 3 convenient Urgent Care Centers Full range of medical services in town Find After Hours Providers on our website: healthcenter.ucsc.edu
8 Health Insurance Required for all students Automatically enrolled in the University Health Insurance Can waive this with proof that your private insurance is sufficient Waiver is annual Enrollment in the University insurance is automatic unless waived by the deadline!
9 Choosing Insurance Compare the critical features of the health insurance plan: Premium Cost Deductible Co-pays Co-insurance
10 Vocabulary of Insurance Premium: the money you pay to be enrolled in an insurance plan, typically paid monthly Some people pay no premium because their job pays it as a benefit of the job Some people have to pay the premium to cover their families Copay: Money you pay for each visit when you see a health care provider or for a prescription
11 Vocabulary of Insurance Deductible: The money you must spend before any insurance benefit begins Coinsurance: The portion of the cost of care that you pay. Typically given as a percent of the total cost. For example, UCSHIP coinsurance is 85%/15%. After the deductible, the student is responsible for 15% of costs
12 Some More About Insurance Insurance companies sell a plan to an employer The employer chooses the type of plan they will offer their employees The card will tell us the name of the insurance company (Anthem Blue Cross PPO) It does not tell us anything about your particular plan
13 Insurance Company Confusion Student Health Center is not a provider on any other Anthem plan Student Health Center is not a preferred provider or contracted with any other insurance plan We do not submit bills to other insurance companies to seek reimbursement for services
14 UC SHIP Anthem/Blue Cross PPO plan Cost: $805 per quarter or $2,415 full year Excellent, comprehensive coverage year round and world wide Includes dental and vision coverage Monthly fee would be $ ( but must be paid quarterly)
15 UC SHIP Plan No charges for care at Student Health Center $25 Co-pay for primary care and specialist care off campus (with referral) $20 co-pay for outpatient mental health care Co-Insurance is 15% after deductible Deductible is $300 Deductible is waived at Student Health Center
16 USHIP Health Plan Benefits No pre-existing condition exclusion No maximum life-time benefit 100% coverage for preventive care services Out of Pocket Maximum: $3,000 for in-network care $6,000 for out-of-network care No limit on pharmacy prescription benefit
17 Pharmacy Benefit Student Health Center Pharmacy Ventegra* Pharmacy Generic Brand Name Non-Formulary and Brand Name $5 $25 $40 $10 $40 $60 Ventegra Pharmacies include UC Medical Centers, CVS, Safeway, Walgreens and many more. *Using a non-ventegra pharmacy can result in the addition of handling fees which could be passed through to the patient.
18 UC SHIP Service Student Health Center In-Network Provider Out of Network Provider Medical Care 100% $25 co-pay* 60% covered* Behavioral Health 100% $20* 60%* Preventive Care 100% 100% (no deductible)* 60%* Urgent Care 100% $25 60% *Requires Referral from Student Health Center for Coverage
19 Other Considerations Are there any geographic boundaries for your private plan? Some Medi-Cal plans are limited to the county where the student lives Some plans are very local in their provider lists Are there providers who accept your plan here in Santa Cruz? Need to make sure the providers listed on your panel are Actually Taking New Patients
20 The 30 mile Radius Rule New in 2014 Must be able to identify a primary provider on your insurance within 30 miles of the students local Santa Cruz address Waiver available upon appeal for specific situations
21 Affordable Care Act (ACA) An alternate option to explore Created a set of insurance plans you can purchase outside of an employer plan Covered CA website allows you to find plans here which would meet your needs Competitively priced plans Some limitations on available providers Some limitations on when you can sign up
22 Example of a $10,000 Surgery comparing UCSHIP to ACA Plan Types Type of Plan Premiums Out of pocket Plan Pays You Pay Out of Pocket UCSHIP Moderate Low 85% 15% $3,000 Catastrophic Lowest Highest Varies Varies Unknown Bronze Lower Higher 60% 40% $4,000 Silver Moderate Moderate 70% 30% $3,000 Gold Higher Lower 80% 20% $2,000 Platinum Highest Lowest 90% 10% $1,000
23 Care at the Student Health Center Any registered student can be seen Fees vary by insurance status Fees vary by type of medical visit Visit with registered nurse (triage nurse) is free Triage nurse and patient will determine plan of care which best meets their needs
24 UC SHIP at Student Health Center Office Visit No Fee Rapid Strep Test No Fee CBC No Fee Mono Spot No Fee Outside Lab Throat Culture: $28.54 (includes the draw fee or $22.00)
25 UC SHIP Insurance Outside Throat Culture Fee = $28.54 Plan covers 85% of fees Out of pocket (15%): $4.28 Appears on Student Account as Health Center fee
26 No SHIP Insurance Office Visit Fee (99203) = $179 Rapid Strep Test = $42.00 In House Throat Culture = $51 CBC, Mono Spot = $63 Total Visit = $335
27 No Ship Insurance Fee appears on the Student Account Itemized Billing Statement goes to student via Health E- messenger Student responsible to submit to private insurance for coverage Student Health Center can t predict coverage
28 Cruz Care $90 every quarter Visits to Student Health Center for illness and injury are free Tests and x-rays done for illness and injury in the building are free Doesn t pay for medicine, supplies, physicals and most procedures
29 Cruz Care Office Visit Fee = 0 In House Rapid Strep Test Fee = 0 CBC, Mono Spot = 0 Outside Lab Throat Culture = $28.54
30 Insurance Coverage UC SHIP NO SHIP CRUZ Care Office Visit Fee (99203) In House labs Out of Office Labs Total Visit Costs None $179 None None $156 None $28.54 $ $4.28 $335 $28.54
31 You can Waive If Your Plan Has NO preexisting condition exclusion (or met) Has NO lifetime maximum Has an annual Out of Pocket maximum of less than $6,350, unless there is a health savings account (includes deductible, coinsurance, copays) Has NO per injury/illness maximum Has an annual deductible of less than $6,350 Has a primary care provider within 30 miles of local Santa Cruz address
32 You can Waive UCSHIP If Your Plan Covers hospitalization for physical and mental health conditions Covers outpatient visits for medical and mental health conditions Covers prescription medications Covers care for illness and injury caused by alcohol or drug use Covers services related to injuries from all recreational or amateur sports
33 You can Waive If Your Plan (cont ) Covers ACA essential health benefits including: Preventive care physicals, most immunizations, laboratory/diagnostic tests to determine your state of health Emergency room services Diagnostic services including laboratory tests Chronic disease management Medications incl. contraceptives (women & men) Pre-natal & maternity care (women & men)
34 Health Insurance How to Waive Sign in to UCSC Student Portal: View Messages Follow instructions in message from the UCSC Student Insurance Office
35 What If Something Changes? Student Health Insurance or Cruz Care can be purchased prior to each quarter You can enroll in the Student Health Insurance outside of standard enrollment dates under certain circumstances. Call for more information More questions? Visit the Student Health Center website, under the heading Insurance
36
37 Hepatitis B Mandatory three shot series Typically given to small children Required by State of California to attend UC Complete on-line form at
38 Whooping Cough is also called Pertussis GET IMMUNIZED! Get a TdaP booster
39 Meningococcal Vaccine Can Prevent This!
40 AVOID THE FLU! GET AN ANNUAL FLU SHOT!
41 Communication Under 18 requires parental consent for care Parents can expect to hear from us Over 18, students have a right to privacy which means we can not disclose information to anyone including parents, without their permission
42 Students with Special Medical Needs Contact our patient care coordinator to arrange transition to school: Beth Hyde, NP
43
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This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.sharphealthplan.com or by calling 1-800-359-2002. Important
National Guardian Life Insurance Company: Earlham College Student Health Insurance Plan Coverage Period: 08/01/2015-07/31/2016
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.studentplanscenter.com or by calling 1-800-756-3702.
Small group and CalChoice benefit comparison
Small group and CalChoice benefit comparison effective July 1, 2015 We believe in choice. A guide to choosing the right plan for your business US health plan 1 San Diegans choose Sharp Health Plan With
Coverage for: Individual, Family Plan Type: PPO. Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.bbsionline.com or by calling 1-866-927-2200. Important
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.studentplanscenter.com or by calling 1-800-756-3702.
Important Questions Answers Why this Matters:
HealthKeepers Anthem HealthKeepers 20 POS / $10/$20/$35/20% Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2015-12/31/2015 Coverage For: Individual/Family
Boston College Student Blue PPO Plan Coverage Period: 2015-2016
Boston College Student Blue PPO Plan Coverage Period: 2015-2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual and Family Plan Type: PPO This is only a
Small Employer Health Insurance. Avera Health Plans One team. Connected. Caring for you.
Small Employer Health Health Plans One team. Connected. Caring for you. Health insurance is a critical factor in retaining and recruiting employees When was the last time you quoted with Health Plans for
Massachusetts. Coverage Period: 7/1/2013 6/30/2014 Coverage for: Individual + Family Plan Type: HMO
Harvard Pilgrim Health Care, Inc. The Harvard Pilgrim Best Buy Tiered Copayment ChoiceNet HMO Summary of Benefits and Coverage: What this Plan Covers & What it Costs Massachusetts Coverage Period: 7/1/2013
Kaiser Permanente: Platinum 90 HMO
Kaiser Permanente: Platinum 90 HMO Coverage Period: Beginning on or after 01/01/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: HMO
StudentBlue University of Nebraska
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: PPO What is the overall deductible? This is only a summary. If you want more details about
What is the overall deductible? $250 per person/$500 per family. Are there other deductibles for specific services? No.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.etf.wi.gov or by calling 1-877-533-5020. Important Questions
Covered Services: All plans offered on the Marketplace cover 10 Essential Health Benefits:
Introduction The NY State of Health 2015 Plan Compare provides information about health plans offered on the Individual Marketplace. Here's some general information to get you started. Metal Levels: Plans
In-network: $5,000 per insured/ $10,000 per family per calendar year. Out-of-network: $10,000 per insured / $20,000
Regence BlueShield of Idaho: Coverage Period: Beginning on or after 01/01/2014 Regence Individual Direct Bronze HSA Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: