Health Insurance for Student Families
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Health Insurance for Student Families
Help! I need dental work and the list of dentists for the UCB
dental insurance coverage is so long...does anyone have a dentist
they use that takes our student insurance and they would
The UCB student dental insurance covers 80% of the costs of using
dentists who aren't on their list, so if you can afford to pay
the other 20% yourself, you have a LOT of choices.
I use Dr. Clopton on Regent St. and really like him--I can get an
appointment within a couple of weeks of when I call, he explains
everything he does, and more than any dentist I've had before,
carefully points out areas where I can do a better job of dental
care myself to avoid having drilling done later.
I've been seeing Michael Young on Solano in Albany for almost 6
years now, and he definitely takes the UCB student insurance.
I've never had anything but cleanings and x-rays but my daughter
has had a couple of fillings done. I've always been pleased with
his work; it is a small, friendly office and they schedule my
daughter and I together so we only have to go in once.
I go to University Dental at Solano/San Pablo Ave in Albany. Their phone number is
510-528-7216. I have seen 3 different
dentists over the last 5 years, and I think that all the dentists
in the practice are excellent. The best part is that you just
give them your student ID while making an appointment, and they
get all the information directly from Tang center records and
SHIP insurance. No filling out forms or hassles. It is very
easy to get an appointment within 2-3 days and same day for
emergencies. The front desk lady is wonderful. She would work
patiently with you and maximize your benefit. For example, I
needed 4 molars extracted last year. The maximum SHIP allows is
$1000 for a calendar year. So she suggested to get two
extractions done in December and two in January! That way it was
all covered, leaving some for twice a year cleanings. I could
even chew on one side while the other side was sore for a couple
of days after extraction. There are coupons for extras, such as
teeth whitening (not covered by SHIP) in the Guide to Good Life
at Berkeley book. Overall, the office is very nice and makes you
feel that they care about you, and do their best to accomodate
your needs and budget as a student. They even pick you up from
campus! happy teeth
University Health Services can help you learn about and get connected to the health insurance options available for dependents. We are knowledgeable about a variety of individual private insurance plans as well as community-based plans, both publicly supported and nonprofit. Please start by visiting our web site,
which includes descriptions of the available plans and links to the plans' web sites. You can start the selection process by reviewing the plans and evaluating their benefit levels and prices. When you are ready for additional assistance, please call or stop by the Student Health Insurance Office on the third floor of the Tang Center, (510) 642-5700.
Heather Pineda, MPH
Health Plan Administrator
University Health Services
University of California, Berkeley
Does anyone have experience fighting with SHIP and Blue Cross
for pregnancy and delivery issues?
After THREE DAYS of being induced at Alta Bates, I finally went
into labor and didn't need a C-section. Nevertheless, my
doctor practically ordered me to get an epidural since I was
exhausted. The anesthesiologist on duty that morning is not
part of the network and SHIP refused to pay any of the 80%. I
complained because I didn't have any choice in the provider and
Alta Bates is supposedly covered by SHIP. They reduced the
$800 balence by $50, which is unacceptable to me.
In the meantime, the anesthesiologist was about to send a
collection agency after me, so I have written another letter to
SHIP demanding that they pay more of it or I will go to the
State Board of Insurance. I will call Blue Cross directly
again and the anesthesiologist may give me a discount.
SHIP refused to pay for my week-long hospitalization when I went
into labor at seven months, stating that my labor was not an
emergency and I did not need to be hospitalized. My doctor wrote
an angry letter to the insurance office, and the bill was paid.
Have your doctor write a letter stating that your epidural was
necessary. That should do it. The guy over at the Tang Center
seems to authorize as little as possible. I am still trying to
get them to pay for lab bills from over a year ago!
I had Blue Cross PPO and delivered at Alta Bates last year, and
the epidural wasn't covered. None of their anesthesiologists
are covered. I mentioned this problem to my OB/GYN who suggested
that my only recourse was to negotiate with the Anesthesiologist:
''send a letter, a check, and say 'this is how much I'm willing
to pay'''. I asked Blue Cross what their adjusted/allowable
amount was for the epidural and I paid a little more than that
as a reasonable basis for compensation. It was about half of
the invoice. I never heard from the anesthesiologist again.
Of course, I handled this matter within 2-3 weeks of receiving
The anesthesiologist's billing service suggested that I write a
letter to the doctor pleading a hardship case. I think you
should try your hardest to negotiate with the doctor to
forestall your account going to collections in order to save
your credit rating. A token partial payment might help get a
dialog going. It will at least buy you time to complete your
efforts with insurance.
By the way, last I heard, the only Pediatricians in the East Bay
accepting Blue Cross was Summit Pediatrics in Orinda.
To the person who had trouble with her insurance paying for her delivery
bills. I missed your letter, but here is some useful info. of organizations
that may be able to help you.
Office of the Patient Advocate 1-866-466-8900 www.opa.ca.gov
HMO Help Center : 1-888-HMO-2219 www.hmohelp.ca.gov
California Patient's Guide : www.calpatientguide.org
Department of Insurance 1-800-927-4357 www.insurance.ca.gov
You can also request an Independent Medical Review to settle the issue.
Call the HMO Help Center and they should be able to help you start the
DHIP rates just went up another 20% !! Can anyone recommend an alternative to
the university's DHIP program? (they sell Blue Cross California Care HMO to students
w/ dependents) The current rate for 3-party family is $1278 (that's $142 per person,
per month). Seems like a lot... What are other people doing for health care coverage
for their spouse/kids if they don't receive it from their employer? Recs for other
plans or agents would be greatly appreciated... also, some figures regarding what
people are paying monthly for their coverage. Thanks, Holly.
I got a flyer in the mail the other day that addresses this topic. Seems that
Kaiser offers a "personal advantage" plan to individuals and families. $15 office
visits, $10 copay for Rx. Assuming one spouse is under 40 yrs, a family plan would
be $338/mo for both parents and all children. For just one parent and one child
it would be $194/mo, and for one child only it would be $69/mo. There are many
more options. The flyer said: "To obtain a no obligation enrollment kit, call
1-800-325-6662. Applicants are subject to a medial review." Good luck!
I know what you mean! We bailed out of DHIP long ago for a private insurer (Frankel
Ins.?) whose rates were cheaper than DHIP -- the way it was explained to us, DHIP
is higher because of the pregnancy coverage -- the California Care HMO we got
through Frankel Ins. was exactly the same as the DHIP coverage, but with an additional
$1,000 co-pay in case of pregnancy. But eventually even that got out of hand --
we were billed monthly, and it got to be close to $400/mo. I struggled with whether
to get on the Healthy Families program (which is a very good program, if you haven't
already checked them out), but I couldn't bear to give up my pediatrician. Finally
I decided to go directly to Blue Cross and change our coverage from a $10/co-pay
to a $40/co-pay. This reduced our monthly premium to $156. It works for us --
good luck! MMRivas
If you haven't already, check out http://www.ehealthinsurance.com. You can browse
a variety of plans and experiment with different copayments/deductibles to determine
your costs. Good Luck!
SHIP and mental health benefits
Those people interested in seeing a marriage counselor or undergoing
other therapy should know that SHIP (Student Health Insurance Plan)
covers up to 600$ of outpatient
psychotherapy per calender year. The maximum reimbursement per visit
is $40. Since the coverage is per calender year, you can see a
therapist for sessions spanning Nov-March, for instance, and get $1200
paid for through your insurance! I'm not sure whether or not staff
are covered in a similar way, but this is certainly worth pursuing for
this page was last updated: Dec 26, 2011
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