Student Health Insurance Plan (SHIP)
The Student Health Insurance Plan (SHIP) is an Alliance Select plan, which provides coverage for preventive care, hospitalization, surgery, maternity, well-baby/well-child care, emergency care for accidents or illness, medically necessary physician care, prescription drugs and mental health.
How an Individual Uses SHIP
Health care under this plan is provided by various groups of health care practitioners, suppliers, agencies, programs, and facilities called Select Providers who have agreed to join with Blue Cross and Blue Shield of Iowa to offer each student affordable health care. One hundred percent of the hospitals and more than 4,000 physicians in Iowa participate with the Alliance Select plan.
Non-participating providers do not have contracts with Blue Cross and Blue Shield. They do not agree to accept payment arrangements and are not responsible for filing claims for you. Non-participating providers may charge more for health care than participating providers. Payment is made to you and you are responsible for paying the provider. Non-participating providers can bill you for the difference between what Blue Cross and Blue Shield will pay for a service and what they charge (balance billing).
Students may also purchase coverage for their spouse or domestic partner and/or dependent children.
Students are urged to take advantage of the services of UI Student Health and Wellness when they need health care. Unlimited office visits for General Medicine Services, Surgery, Allergy Treatment, Sexually Transmitted Diseases, Mental Health Services, and the Health Iowa education program are included in a mandatory health service fee which is included in tuition charges if a student is enrolled for five (5) or more semester hours of classes. Students who are enrolled for less than five (5) semester hours may choose to pay the health fee and obtain these same benefits.
The Student Health Fee does not cover lab tests, supplies, physicals (including annual gynecological exams), immunizations, procedures (such as wart removal) and other costs.
Many Services that are not covered by the Student Health Fee are available at Student Health and Wellness - such as laboratory and imaging services, physicals, annual gynecological exams, etc. Any charges incurred for such services are the responsibility of the student. SHIP may be used to pay for some of these services.
Family members are not eligible to use Student Health and Wellness. To receive the greatest benefits from SHIP, dependents are advised to use the physicians from the Alliance Select Provider list.
How Much an Individual Pays for Health Care Services
Per Service Co-payment/Co-insurance Amounts
|Select Provider||Non-Select Provider|
Office Visit: $10 co-payment per visit for office visits and diagnostic imaging and lab services
Office Services: $30 co-payment per visit for office visits and diagnostic imaging and lab services
Outpatient Facility: $50 co-payment per visit for surgery, emergency room, and ambulatory surgical centers
Outpatient Facility: $150 co-payment per visit for surgery and ambulatory surgical centers
Hospitalization: 10% co-insurance after $300 deductible
Hospitalization: 20% co-insurance after $600 deductible
Out-of-Pocket Maximum (OPM) Expenses for Individuals
SHIP provides a $1,000 out-of-pocket maximum per hospital inpatient admission.
The out-of-pocket maximum equals the per-service deductible plus the coinsurance amounts paid during each inpatient hospital stay.
When the amount paid by the insured equals the OPM, the plan pays 100% of the covered charges incurred for that admission.
Coverage for Prescription Drugs
Prescription drugs are covered under a 3-tier plan.
- Generic drugs- you pay 25%
- Name brand formulary drugs- you pay 30%
- Name brand non-formulary drugs- you pay 50%
Formulary drugs are drugs that are on Wellmark's preferred list.
If you purchase a brand name drug when an FDA-approved “A”-rated generic equivalent is available, you are responsible for your co-payment or coinsurance, plus any difference between the billed charge for the brand name drug and the billed charge for the generic. This can result in you paying substantially higher costs than if you had chosen the generic drug.
If your physician feels it is important for you to have the brand name drug, they can write the prescription for the brand name drug with the direction, “Dispense as Written” on the prescription. In this situation you will not be responsible for the difference between the billed charge for the brand name drug and the billed charge for the generic drug.
Limitations and Exclusions
Certain services are limited, excluded, or not considered medically necessary under SHIP. Dental check ups, and eye exams are not covered under SHIP. Dental Services are limited to accidental injuries treated within seven days of the injury and limited surgical corrections to the jaw, mouth, and accessory sinus. Injuries to the eye have limited coverage.
Alliance Select Care Providers in Iowa
Covered individuals may use any provider they choose for physician and other office and outpatient services. However, your financial responsibility is greater if you use Non-Select Providers. All hospitals in Iowa are Select Providers.
Health Care for Individuals Who Are Away from Iowa
SHIP provides coverage world wide. For covered services received in other states or outside of the USA, the provider category may be Select or Non-Select when determining payment amounts. Choosing a Select provider can be an advantage when receiving treatment.
The insured is responsible for telephoning the Blue Cross and Blue Shield of Iowa toll-free number before being admitted to a hospital for non-emergency care and within 24 hours of emergency and maternity admissions.
Medical Evacuation Benefit
The University of Iowa SHIP will cover medical evacuation services in the event of illness or injury to students if necessary and adequate medical care cannot be provided at the location when the illness or injury occurs.
Medical evacuation benefits cover expenses to the nearest appropriate medical facility. Precertification of medical evacuation services is required.
Repatriation benefits cover expenses incurred in returning the body to the person's place of residence in his or her home country including, but not limited to, the cost of embalming, the coffin, and transportation of the body.