APM 430 Student Services Fees and Insurance Options | Graduate Education and Postdoctoral Affairs

Applies to APM 430 student programs with start or renewal dates of September 1, 2021 onward*

Departments are required to purchase primary insurance coverage and student service fees on behalf of international APM 430 students staying at UCSF for 90 days or longer.* Departments must purchase APM 430 international students’ primary insurance through the specific vendors vetted below by SMHW (see insurance options).

This policy is optional for departments sponsoring domestic APM 430 students for at least 90 days or longer. If the department opts in to purchasing this insurance for domestic students, the department must purchase the insurance AND pay for the SMHW fee.

Estimated Fees

Item	Estimated fee**	How fee is assessed
SMHW-vetted primary care insurance plan (international student)	Approximately $500 - $700 or more per academic quarter (calculated based on a min. 90-day appointment), depending on coverage plan selected and student's date of birth. These are just estimates, and your actual plan may vary from this range. You should be prepared to see a higher or lower per month cost.	Department purchases directly through respective SMHW-vetted insurance company. This is not paid to UCSF, which is why the department must work with insurer directly. The host department/PI will use BearBuy to make these purchases. Please see the separate enrollment procedure pages for Student Medicover and PSI. This only applies to international students whose appointments are 90 days or longer.
Student Services Fee (allows direct access to SMHW)	$261/month	GEPA charges through chart of accounts or SpeedType. This chart string will be included on the bottom of page 2 of the insurance and supplemental fee form. This only applies to international students whose appointments are 90 days or longer.

Item

Estimated fee**

How fee is assessed

SMHW-vetted primary care insurance plan (international student)

Approximately $500 - $700 or more per academic quarter (calculated based on a min. 90-day appointment), depending on coverage plan selected and student's date of birth. These are just estimates, and your actual plan may vary from this range. You should be prepared to see a higher or lower per month cost.

Department purchases directly through respective SMHW-vetted insurance company. This is not paid to UCSF, which is why the department must work with insurer directly.

The host department/PI will use BearBuy to make these purchases. Please see the separate enrollment procedure pages for Student Medicover and PSI.

This only applies to international students whose appointments are 90 days or longer.

Student Services Fee (allows direct access to SMHW)

$261/month

GEPA charges through chart of accounts or SpeedType. This chart string will be included on the bottom of page 2 of the insurance and supplemental fee form.

This only applies to international students whose appointments are 90 days or longer.

**UCSF fees subject to change without notice

UCSF fee assessment: The student services fees are charged through the department’s chart of accounts (COA) or SpeedType. Checks are not accepted. Departments are responsible for purchasing one of the primary care insurance plans vetted by UCSF’s SMHW (see insurance options below). Primary insurance coverage fees and UCSF fees should not be assigned to the APM 430 student.

Insurance Options

PLEASE NOTE: Selecting an insurance plan outside of the four listed below will cause your APM430 appointment request to be rejected. No plans outside of the four listed below are pre-approved with Student Mental Health and Wellbeing.

In collaboration with visiting students, departments are required to purchase APM 430 students’ primary insurance through specific vendors vetted by SMHW. Unfortunately, alternative insurance plans do not meet the Graduate Education and Postdoctoral Affairs’ insurance requirements, including plans offered through foreign governments/institutions. If a non-SMHW-approved insurance policy is initially purchased, the plan will need to be canceled at the cost of the Department and the SMHW-vetted plan must be purchased prior to approving the APM 430 student appointment.

The only insurance options approved by SMHW, offered by PSI and MediCover, are below. (follow links below for rates)

PSI Options

Once you get to this selection above, the eligibility status for both PSI options is "Full-Time J1 Visa Student".

MediCover Options

Insurance Plan Comparison

Coverage subject to change annually. Check respective insurance websites for most recent info.

Description	PSI CA Platinum 0 Plan	PSI CA Platinum 100 Plan	Student Medicover - Elite	Student Medicover - Prime 100
*Departments are responsible for purchasing SHCS-approved primary insurance coverage and independently understanding/complying with the insurance company’s policies, including cancellation/amendment policies. Graduate Education and Postdoctoral Affairs is unable to intervene on behalf of departments or students regarding insurance matters.
					Eligibility	Visiting scholars, optional practical training students and formal English as a Second Language program students with an F1 or J1 visa are eligible to enroll in this insurance plan.	Visiting scholars, optional practical training students and formal English as a Second Language program students with an F1 or J1 visa are eligible to enroll in this insurance plan.	Visiting scholars, optional practical training students and formal English as a Second Language program students with an F1 or J1 visa are eligible to enroll in this insurance plan.	Visiting scholars, optional practical training students and formal English as a Second Language program students with an F1 or J1 visa are eligible to enroll in this insurance plan.
U.S. Provider Network	Aetna	Aetna	UnitedHealthcare	UnitedHealthcare
Maximum Benefit Payable	Unlimited	Unlimited	Unlimited	Unlimited
Lifetime Maximum	Unlimited	Unlimited	Unlimited	Unlimited
In-network Deductible	$0	$100	$0	$100
Out-of-network Deductible	$100	$250	$500	$300
Plan Coinsurance In-network	80% Preferred Allowance	80% Preferred Allowance	90% Preferred Allowance	80% Preferred Allowance
Plan Coinsurance Out-of-network	70% UCR	70% UCR	70% UCR	70% UCR
Outpatient Office Visit Copayment - In-network	$25	$25	$20	$25
Outpatient Office Visit Copayment - Out-of-network	$25	$25	70% UCR	70% UCR
Emergency Room Copayment - In-network	$100	$100	$150	$200
Emergency Room Copayment - Out-of-network	$100	$100	$150	$200
Urgent Care Copayment - In-network	$50	$50	$50	$50
Urgent Care Copayment - Out-of-network	$50	$50	$50	$50
Out-of-pocket Maximum - In-network	$6,350	$6,350	$5,000	$6,350
Out-of-pocket Maximum - Out-of-network	Unlimited	Unlimited	$7,000	$8,000
Pre-Existing Conditions	Pre-Existing Conditions are covered without a Waiting Period	Pre-Existing Conditions are covered without a Waiting Period	Prime, and Elite plans do not have limits on pre-existing conditions.	Prime, and Elite plans do not have limits on pre-existing conditions.
Diagnostic Testing (x-ray, laboratory, MRI, PET, CT) In-network	80% Preferred Allowance	80% Preferred Allowance	90% Preferred Allowance	80% Preferred Allowance
Diagnostic Testing (x-ray, laboratory, MRI, PET, CT) Out-of-network	70% UCR	70% UCR	70% UCR	70% UCR
Therapeutic Services, Physical Therapy, Manipulative, Cardiac Rehab, Vocational and Speech Therapy, and Acupuncture - In-network	80% Preferred Allowance	80% Preferred Allowance	$30 copay	$30 copay
Therapeutic Services, Physical Therapy, Manipulative, Cardiac Rehab, Vocational and Speech Therapy, and Acupuncture - Out-of-network	70% UCR	70% UCR	$30 copay	70% UCR
Mental Health Outpatient Visit - In-network	$25	$25	$20	$25
Mental Health Outpatient Visit - Out-of-network	$25	$25	70% UCR	70% UCR
Prescription Drugs	$20 copay Tier 1 $40 copay Tier 2 $60 copay Tier 3	$20 copay Tier 1 $40 copay Tier 2 $60 copay Tier 3	$15 copay Tier 1 30% Coinsurance Tier 2 50% Coinsurance Tier 3	$15 copay Tier 1 30% Coinsurance Tier 2 50% Coinsurance Tier 3