As a graduate student at UCSD you will automatically be signed up for GSHIP (the Graduate Student Insurance Program), the fees for which are paid for by the mathematics department as long as you are employed by them. Your insurance card can be printed out online from where you will also find details about the insurance. (A link to the current plan is usually kept at https://wellness.ucsd.edu/studenthealth/insurance/Pages/default.aspx as an answer to the first question among their FAQ section.)
As a broad overview, you should know that the insurance is a PPO (meaning you are welcome to go to any doctor you wish, but a certain set of doctors – mostly those at the UCSD medical centers and on UCSD’s campus – will be more fully covered by your insurance). As a basic rule, if you are healthy, your medical costs should be low or nonexistent while at UCSD and will be easily arranged through doctors on campus. If you have more complicated medical needs, you should look through the fine print at the link above. Below, we’ve attempted to give some of the details, but be aware that insurance is complicated, and the following information should be verified through the insurance plan. If you are at all confused, a section of SHS (see below for more information about SHS) has multiple insurance specialists, who will be happy to answer your questions, usually with little or no waiting.
Before we go into details, one piece of advice: Unless you are constantly ill, it is unlikely that you will remember a lot of the following details. If you are likely to use a parent or non-UCSD grad student as your emergency contact, you should consider forwarding this sheet and/or a copy of your insurance booklet now. This way, if you find yourself in a situation where you need this type of information, you can have easy access to it with a phone call, especially since the link above is fairly hard to search for and the UCSD student health clinic is easily confused online with some unrelated UCSD clinics with similar names.
The following list gives details on the several standard places to get medical advice or help using the UCSD medical insurance. Be sure to read beyond this list for the basic financial and paperwork type details that you will need to know to arrange for an appointment or get medical coverage.
- UCSD Student Health Service (SHS) – This is the on campus doctors’ offices that for most of us provides all necessary medical care, including checkups, vaccines, gynecology, xray, lab tests, a pharmacy, optometry, etc. You can either schedule an appointment or walk into their urgent care center.
- CAPS (or Counseling and Psychological Services) – This is the group of psychologists and psychiatrists available to students on campus either through support groups or one on one sessions. Their offices are spread throughout campus, in part to better preserve their patients’ anonymity.
- Advice Nurses – With a recently added service, we now have telephone access to nurses around the clock, which is especially helpful if you are unsure of whether or not to find a doctor. During the day, when you call up SHSs appointment line at 858-534-8089, you can ask to be connected to whatever nurses are working in the urgent care center. After hours, you can call 858-534-3300 for a nurse who is employed exclusively to give advice and (unlike the busy nurses at SHS) will commonly spend a few minutes researching your questions before responding if she or he cant answer your question off hand.
- Dentists – UCSD’s health insurance offers limited coverage for dental work. They do not suggest a particular dentist, but there are dentists in a certain network that have agreed to take GSHIP insurance, which makes the paperwork easier. Teeth cleaning is well covered, but some of the more expensive services, like taking care of cavities, are not and tend to be one of the few larger expenses that UCSD students run into. For major dental work, some students have opted to go to Mexico and get the work done at a fraction of the price here in the states.
- UCSD Hospitals at La Jolla (called Thorton) or at Hillcrest – For emergency or weekend care, your insurance coverage is best at these two hospitals. Both hospitals have extensive doctors’ offices and specialty clinics and any specialists that you see are likely to be in one of these two locations. Thorton is within walking distance of UCSD, but UCSD busses will also take you to either location for free. Thorton is much nicer than Hillcrest, but the medical care is the same, with many doctors commuting between the two. Both are highly respected teaching hospitals.
- Outside network hospitals, specialists, or hospitals – Although there are three hospitals (two not afilliated with UCSD) within walking distance of UCSD, you are unlikely to have an appointment outside the UCSD system, mostly because the UCSD system is well respected and is better covered by your insurance than anywhere else. Unless you have an incredibly rare illness, need a second opinion on a dangerous operation, or are out of town, you will probably never get outside the UCSD system. In theory, any ambulance that sees you are a UCSD student will deliver you to a UCSD hospital (within reason) so even in an emergency, you are unlikely to find yourself outside the system.
The basic fine print –
- There are four types of appointments at Student Health Services on campus.
- Urgent Care Appointments – Walk into SHS, fill out a short form, and then wait to see the next available doctor. There is a triage system, so this is certainly where you should go first in an emergency (unless it is sufficiently serious that you opt to head for the hospital.) The wait time can be quite long otherwise, although it is not too bad first thing in the morning. Note that no one is ever turned away by the urgent care clinic (unless they show up too late to be seen.) For this service, there is a $15 copay, unless you are admitted into the hospital.
- Same Day Appointments – A few appointments are saved each day, but they are usually already gone by midmorning. You should always try to arrange for these appointments over the previous ones, since you have some control over which doctor you see and the appointments are free. You can ask for one by calling 858-534-8089, but you should expect to be turned down and either sent to urgent care or to a standard appointment sometime in the future.
- Standard Appointments – Standard appointments can be made for non-urgent care, standard checkups, etc. Appointments with the few specialists on campus (like optometrists or dietitians) need to be made by phone at 858-534-8089. Other appointments can be made online at http://studenthealth.ucsd.edu/AboutAppointments.shtml, although the online process is a huge pain. Be aware that it is not unusual for the first available appointment to be several weeks away. Your standard appointment with a doctor or physician’s assistant is free, but some of the specialists cost, so if in doubt you should ask or look it up on SHS’s website. (An eye exam for contact lenses is the only relatively expensive and commonly used service.)
- Mental Health Related Appointments – These are free and are arranged for by phone. Be aware that you will be asked to fill out fairly extensive surveys the night before your first appointment. Appointments can be made by calling 858-534-5755. You can find out about specific therapists at http://caps.ucsd.edu/, although the wait time to see a therapist can be long, especially around finals time for the undergrads and requesting a certain therapist will increase the length of the wait.
- SHS has a blood lab and an x-ray lab. Both are either free or cheap and convenient when you have a broken bone.
- SHS also has a pharmacy, which offers a long list of generic drugs at $15 per month and name brand drugs at $30 per month. If you are on a generic drug for a length of time, you should look to see if you can get it cheaper through one of the $4 drug programs at Walmart or various grocery stores, but otherwise, the coverage is good. If you need a drug they dont carry (which is rare), with few exceptions, you will need to buy it from an outside pharmacy and submit a claim to insurance so that they will pay a portion of the cost.
As a general rule, if you find yourself in an emergency, you should contact our insurance early and often for better coverage. In an emergency –
- If it is a true emergency, you should (of course!) head straight to the nearest hospital. If you have a choice, you should be brought to a UCSD hospital. If you have an emergency admittance overnight, you will need to call our insurance company (with the phone number listed on your insurance card) within the first twenty four hours to make sure that your continued stay will be covered. (For less than twenty four hours, you are not required to make the call.)
- If you have a slightly less urgent medical problem and are in the San Diego area, you will need to first see a doctor at SHS who will then decide if a hospitalization is appropriate. (This rule is relaxed on the weekends and at night, when the emergency room is the only place available for medical care.)
- If you have a slightly less urgent medical problem and are further from home (even overseas) you should call the insurance company in advance of going to a hospital. Among other reasons, they will try to direct you to a hospital with which they have a financial agreement, and they will pass some of these savings on to you.
- In general, service outside SHS requires you to pay a large (several hundred dollar) deductible before you receive any insurance break. Once you have paid the deductible, the amount that is covered by GSHIP is a percentage between 60% and 100%. The highest percentage corresponds to UCSD doctors, while the lowest is for doctors who have never made prior arrangements with GSHIP. Frequently you can get better coverage (especially when outside the San Diego area) by asking the insurance company with whom they have pre-existing agreements.
If you find yourself needing a specialist (outside the few that can be found on campus) you will always need to arrange this through a primary care doctor at SHS. For specialized help –
- Your primary care doctor will write you a referral form, usually restricting you to UCSD doctors. (If there is a medical reason that you need to be seen by someone outside the system, they will usually warn you repeatedly that going outside the system costs more, but will then change the form.) An office assistant will then fax your referral to the Hillcrest or La Jolla UCSD hospitals (usually your choice as to which one) and then either make the appointment for you or give you a number to call to arrange for the appointment.
- Do not be surprised if it takes a while between the time that your form is sent and the time that you are allowed to make an appointment, since the hospitals check for your insurance coverage before they will make an appointment. Once they are ready to make an appointment, it may be a fairly long time before they will schedule your appointment. If it is really urgent, your primary care doctor may be able to speed up the process, but only in really urgent matters. If you want to decrease the wait, check to see if you can get in at one hospital more quickly than the other.
- You will be given a copy of your referral form by your primary care doctor. You should have it in your hands during your appointment with a specialist, so that you know what can be ordered by the specialist without going back through your primary care doctor. Along the bottom of the standard form, there are a number of boxes that a doctor can choose whether or not to check. It also includes the length of time that your referral is good for (at most one year) before you will need to return to SHS for a new referral. Any appointments made after the time limit will not be covered by GSHIP without a new referral, so keep an eye on the expiration date for chronic illnesses.
- You should be aware that if a specialist orders lab tests, even if your referral form allows him to do so directly and you have them done at the UCSD hospital, you will be charged unless you have already fulfilled your deductible for the year. A better plan is to ask them to request the tests on the final report that they hand you on your way out the door (a general summary of your appointment and any drug changes) and then hand the request to your primary care doctor, who can then arrange for these test to be done (for free or cheap) through the labs on campus. Depending on the details, the nurses in urgent care can also OK the request, and they are more likely to do so on the spot and without charge if you go to the urgent care clinic. Be aware that many tests are sent from SHS to another lab, unlike at the UCSD hospitals, so results are sometimes slower to be returned.
- Similarly, you should ask that all of your prescriptions be handed to you in paper form and then should take that paper to the SHS pharmacy. (It might be possible to get an electronic prescription sent to SHS, but it is advisable to ask for a paper prescription.) You will not receive the same discount by ordering drugs at one of the hospitals. Most drugs are available at SHS. If the drug is generic, rare, and is ordered by the bottle (usually 100 pills) the SHS pharmacy will sometimes be willing to add a special order for it to arrive the next day, something to keep in mind if you are seeing a specialist.
- Be sure to ask specialists how you should contact them if you have a problem or question after your appointment. Especially since many of them only work out of a UCSD hospital a couple of days a week, this is frequently a problem. Sometimes they will either give you their email address or the phone number of a nurse that can advise you or track the specialist down for more serious matters.