UC Merced students who have waived out of SHIP can be seen at UCM Student Health Services (SHS) for primary care or urgent care issues, however your medical condition may require care that is not available at SHS.
If you plan to waive SHIP, you must first make sure that your insurance provides coverage for non-emergency medical care within 55 miles of UC Merced. This is one of the waiver criterion and will ensure that you have access to necessary medical care in Merced when you need it. Your waiver will be denied if your insurance does not provide coverage within 55 miles of UC Merced. Avoid having your waiver denied and take the necessary steps now to make sure that you have the necessary coverage before you need to use it.
You must contact your insurance company, whether it is Kaiser, Medi-Cal, or a private HMO, to let them know you are attending college in Merced. Ask them if you have coverage for non-emergency and non-urgent care while in Merced. Most HMO plans, including Medi-Cal, require that your non-emergency and non-urgent care be obtained through your assigned medical group or Primary Care Physician (PCP), and will only allow local care if it's an emergency or urgent care. This will be a problem if your medical group or PCP is not located in Merced. Most PPO plans do not have this requirement and will provide coverage in Merced whether emergency, urgent or not.
If you do not have the necessary coverage in Merced, ask your insurance representative how to change your coverage so that you do. You may find the following information helpful as you transfer your insurance coverage to Merced.
UC Merced requires that all students have a primary care provider within 55 miles of their school address (on or off campus). Many students with Medi-Cal, or HMO insurance cannot meet this requirement. If you cannot identify a provider within this 55 mile radius, you may not qualify to waive UCSHIP.
Students with an HMO: Before waiving UC SHIP, please note that HMO plans only covers you for medical care from your designated primary care provider or upon referral from that office. It is not automatically a portable plan. In order to seek non-emergency care in Merced County using an HMO plan, the student must select a new doctor in our area and transfer their care to that person. Please contact your insurance company to change your Primary Care Provider (PCP) to one in Merced.
Students with Medi-Cal: Full coverage is Mandatory and Emergency Medi-Cal is not acceptable. For those students who do not live in Merced, Stanislaus County, or Madera you need to contact your case worker in your home county to let them know you will be attending college at UC Merced. You will need to update your physical address to the one where you will be living in Merced (house, apt., dorm). This will take you out of your current county plan and put you in the Merced County health plan, Central California Alliance. (This is only temporary as you go home for breaks and holidays) This will allow you to seek all services in the Merced area and not just emergency services and will help you qualify to waive out of the UC insurance plan. We will need a copy of the front and back of your county insurance card to be kept on file, please do not send your BIC card.
Access to Medi-cal Benefits for College Students (PDF)
1. Contact Kaiser member services (800) 464-4000 to obtain a Northern Kaiser ID number.
2. Schedule an initial visit with a primary care provider (PCP) at the Kaiser Modesto or Fresno facility.
3. Once PCP is established, most visits can be scheduled online.
And Kaiser Medi-Cal
55 miles of UC Merced
1. Contact the Dept. Of Health & Human Services in the county where
your Medi-Cal was obtained. (Home County) Explain you are attending classes at UC Merced but will still reside in your home county during vacations and school breaks.
2. Once your temporary address has been updated in the State's Medi-Cal database, you should receive a package with information and steps on how to select Central California Alliance. Merced County Code is 24.
3. Call Medi-Cal Healthcare Options at (800) 430-4263 to complete the medical plan selection and assignment process. Make sure you pick a primary care doctor.
NOTE: This process can often take 30-60 days or more to complete and may require long phone calls and multiple follow-up calls. Get started on this process as soon as possible. Your waiver cannot be approved until your Medi-Cal coverage is active and provides non-emergency coverage in Merced.
If you are having difficulty getting your case worker to change your Physical address, you can contact theCalifornia State Ombudsman at:
(888) 452-8609 option #9. Monday-Friday, from 8:00 a.m. to 5:00 p.m.
1. Contact Customer Service or Member Services on your ID card and explain you are attending UC Merced. Let them know you need to change your Primary Care Provider(PCP) to within 55 miles of UCM.
2. Be sure you know how to access medical care when you need it.