USC Student Health Insurance Plan: Covered Benefits through USC Programs
HEALTH INSURANCE PLAN (SHIP) provided through Aetna
Fall 2024 Covered Benefits Reminder
October 2024
Dear USC Students:
Please see the information attached from our USC campus partners that accept the SHIP/Aetna plan:
• USC Pharmacies
• Herman Ostrow School of Dentistry of USC Faculty Practice (accepts Delta Dental plan)
• USC Chan Division of Occupational Science and Occupational Therapy Faculty Practice
• USC Physical Therapy Faculty Practice
• USC Psychiatry and Behavioral Health Services (PBHS, Engemann building 5th floor) clinical practice
• USC Roski Eye Institute (USC Village and Health Sciences Campus)
Overview of SHIP/Aetna plan benefits
Please visit the Aetna Student Health Insurance website for a summary of benefits:
• students attending IN-PERSON programs (categorized as “on campus”); or
• students attending ONLINE-ONLY programs (categorized as “off campus”).
Additional information guides on the Aetna website may be helpful to you
Please remember to print your Aetna insurance card to present when using services outside of Student Health.
Recent Plan Updates
Narcan, recently approved as an over-the counter medication (available without prescription) continues to be a covered benefit with $0 copay.
Coverage has also been added for travel reimbursement for plan members who need domestic travel to obtain abortion care services when they are outside of the state of California. The coverage includes travel for the covered member and a travel companion. (See page 10 of the attachments for details.) The SHIP/Aetna plan also contracts with the "Hey Jane" service that provides telehealth care and FDA-approved medication abortion pills by mail, to plan members in CA, CO, CT, IL, NJ, NM, NY and WA. (See page 11 of the attachments).
New clarification on the coverage of STI testing is included in the attachments, see page 13 for details.
In the 2022-2023 plan year, new coverage was added for gender-affirming care including surgery, behavioral health services, hormone therapy, and fertility preservation (see page 14-20 of the attachments). A care navigator at Aetna can answer your questions, contact the Aetna Member Services line for USC students at 1-877-626-2299 (TTY: 711).
USC Student Health Insurance Plan (SHIP) Office Call: 213-740-9355 (WELL) Email: [email protected]
University of Southern California Los Angeles, California 90089-9034 • Tel: 213.740.9355 (WELL) • studenthealth.usc.edu
The Dental Faculty Practice, located on the University Park campus is a PPO Delta Dental Insurance option. At the USC Dental Faculty Practice, you will receive state-of-the-art treatment from among the finest dentists, specialists and dental hygienists in their fields. Our team is made up of faculty members from the Herman Ostrow School of Dentistry of USC, one of the nation’s top dental schools. From general and preventive dental care to the most advanced specialties and latest breakthroughs, the Dental Faculty Practice is here for students.
We are located in the: Engemann Student Health Center, 4th floor 1031 West 34th Street Suite 401 Phone: (213) 740-2012 Los Angeles, CA 90089 Email: [email protected]
The Herman Ostrow School of Dentistry of USC provides urgent and regular dental care services to students. For information, visit: dentistry.usc.edu/dental-urgent-care-for-usc-students.
Wecanhelpyou:
Create lifestyle balance
Manage stress and anxiety
Improve time management and organization
Improve study skills and procrastination management
Adjust to campus life
Address social or dating anxiety
Create a restorative sleep routine
Develop healthy eating and physical activity routines
Modify your environment to support focus, energy, and ergonomics
Manage chronic conditions
Ifyou’reinterested, sign up for a free 15-minute consultation to assess if this is the right service for you. To do so, sign up through MySHR or call our clinic at (323)-442-3340. Find out more at chan.usc.edu/otfp For any questions, email [email protected], call (323) 442 - 3340 or fax (323) 442 - 3351.
How much time will this take? Sessions are typically held for 30-60 minutes, one time per week, in person or via telehealth. However, every person is different, so ask your OT about what frequency of sessions will work best for you How much will this cost? We can do a complimentary insurance benefits check to tell you if OT sessions are covered by your plan and if any co-pays apply
Hormonal Contraception (Birth Control) prescribed by USC pharmacists
USC International Travel Health Clinic consultations by appointment: Information, vaccines and medications to ensure safe and healthy travels
Narcan / Naloxone ($0 copay)
Smoking Cessation Services
Experiencing muscle or joint pain?
Sports-related injury?
Tech neck?
Repetitive use injury?
YOU HAVE OPTIONS AT USC PHYSICAL THERAPY
PRIMARY CARE-BASED PHYSICAL THERAPY TREATMENT AT ENGEMANN STUDENT HEALTH CENTER
Located on the first and second floors of Engemann Student Health Center. Best option for mild symptoms resolvable in a few visits. No additional costs outside of the Student Health Center fee.
Book appointments directly on MySHR or by calling (213) 740-9355.
USC PHYSICAL THERAPY TREATMENT
Located on both the UPC and HSC campuses.
Best option for patients requiring longer term physical therapy care. Insurance-based, copays may be collected depending on insurance plan. Book appointments by calling (323) 865-1200. 1 2
Complete Eye Care Near You
The USC Roski Eye Institute clinic at USC Village serves the optical needs of Trojan students, faculty and staff and the greater Los Angeles community.
USC VILLAGE
835 W. Jefferson Blvd. Suite 1720 Los Angeles, CA 90089 Mon - Fri: 8:30 a.m. - 5 p.m.
HEALTH SCIENCES
CAMPUS
1450 San Pablo St. Los Angeles, CA 90033
Mon - Fri: 8 a.m. - 5 p.m.
Whether you need an eye exam or are looking for prescription glasses, sunglasses, or contact lenses, our experienced opticians can help. We carry a full selection of optical eyewear from top brands. Bring your valid prescription to any of our locations for purchase of contact lenses and glasses.
Special Offers: Ask us about LASIK and other refractive surgery treatments. Discounts available for USC Staff, Faculty, Students and Alumni!
NEW GLENDALE LOCATION
500 N Central Ave. Suite 400 Glendale, CA 91203 / 323-442-6335 Mon – Fri: 8 a.m. – 5 p.m.
USC Psychiatry and Behavioral Health Services
Clinic overview
Some patients may be best served through an intermediate or longer-term treatment model utilizing their private health insurance or the USC Aetna Student Health Insurance Plan (SHIP). In 2019, to help meet the needs of our students who may require specialized or higher complexity care, USC established the Keck Medicine of USC Psychiatry and Behavioral Health Services (PBHS) on the USC University Park Campus.
PBHS and USC Student Health Counseling and Mental Health (CMH) are both staffed with faculty members from the Keck School of Medicine of USC’s Department of Psychiatry and the Behavioral Sciences, who work in partnership to provide comprehensive and unified care across the USC campuses in order to meet the varied and unique needs of the USC student population. Our faculty are multilingual, multicultural and LGBTQ+ affirming.
Access to psychiatry and behavioral health services
Patients using the USC Aetna Student Health Insurance Plan require an initial evaluation and referral from USC Student Health. All others may refer themselves to PBHS for review of health insurance benefits and scheduling. PBHS is not covered by Kaiser or MediCal at this time.
Care model
While there is no limit to the number of sessions we can provide while you are a student at USC (barring any limit from certain insurance plans), the PBHS care model is designed to provide problemfocused, evidence-based treatment, which is generally 12-15 sessions or 3-6 months, on average. Some patients will need fewer visits, some more. Particularly for patients prescribed certain medications or with certain diagnoses, treatment at PBHS might continue through the entirety of matriculation at USC. We will work in partnership with you to create a care plan that fits your specific needs.
Location: Engemann Student Health Center Building 1031 West 34th Street 5th Floor Los Angeles, CA 90089 For more information, call: (213)764-2800
As part of Keck Medicine of USC, PBHS is contracted with a number of insurers. After the insurance verification process, we consult directly with each patient to explain their expected cost of care.
Aetna Student Health Insurance:
A copay of $10 per visit is required.
Other Insurers:
Not all plans are identical, even from the same insurer. During the verification process we will contact your insurer to help you estimate your cost of care. Please note this is only an estimate and may not match the actual cost of care.
Time to first appointment timeline
The time between referral to PBHS and your first visit may vary depending on your particular needs or preferences and clinician availability. We do our best to ensure your referral will be processed quickly so we can schedule your first appointment as soon as possible.
Referral from USC Student Health • 1-2 days
CMH provider submits referral request to CMH care coordinator (CC)
CC reviews and sends formal referral to PBHS
Patient is registered at Keck Medicine of USC
Insurance verification • 1-3 days***
Insurance information shared with PBHS verifiers
Insurance company contacted for benefits/ deductible, etc.
Appointment scheduling • 1-5 days
Patient contacted to discuss benefits
Patient matched with provider
Patient scheduled with provider
Patient seen at PBHS • 1-15 days (depending on preferences and specializations)
First visit at PBHS
Total time
Average time for referral process: 5-10 days
Total process average time: 15-25 days
***United Health Care (UHC) requires subscribers to contact UHC first and provide permission for PBHS Insurance Verifiers to speak with UHC to verify benefits.
TRAVEL BENEFITS RELATED TO REPRODUCTIVE CARE SERVICES FOR STUDENTS (POST-DOBBS)
We recognize that you may have questions about access to abortion services and related health coverage following the U.S. Supreme Court’s ruling in Dobbs. The Dobbs decision permits individual states to decide to set standards for abortion access, including whether to ban or allow abortion.
Information in this summary document is provided by the Insurance Office of USC Student Health. For detailed questions regarding plan benefits, including steps for filing claims, policyholders are directed to review the plan documents and verify additional details that are available. You may access your Aetna plan online (www. aetnastudenthealth.com) or you may call the number listed on your insurance card.
Benefit amounts are subject to maximum amounts permitted by Internal Revenue Service guidelines, per Federal Travel Limits outlined in IRS publication 502.
For individuals in California, comprehensive reproductive health care is available and protected by state law. Students participating in the Student Health Fee (SHF) while residing in California may see providers in USC Student Health for any of their reproductive care services, including in-person and telehealth visits and consultation for medication abortion, and referrals for procedures outside of ambulatory care.
Students on the USC Student Health Insurance Plan (SHIP, provided through Aetna) may be traveling out of state during the plan year. The SHIP includes travel benefits for certain covered medical services, including abortion care services. This generally means that USC students on SHIP who are outside of California and within the 48 contiguous statements and who must travel a certain distance (domestically) to obtain defined covered services may be entitled to reimbursement of certain travel expenses for themselves and a travel companion. Additionally, the heyjane.com medication abortion service by mail (available in CA, CO, CT, IL, NJ, NM, NY, WA) is available as a covered benefit of this plan.
Who may use the plan benefits?
All policyholders in the current USC Student Health Insurance Plan provided through Aetna (SHIP/Aetna) are eligible. The travel benefit may be used if you need to travel at least 100 miles to access health services for abortion.
Will anyone be informed if I have used these benefits?
No. Your health insurance data is protected health information and is only accessible to you as the policyholder, and the insurance benefits processing teams.
Welcome to your safespace
Private
Get care from the comfort of home (with packaging that’s discreet)
Fast
Consult with a medical provider within 24 hours (M-F)
Supportive
We’re here if you need someone to talk to (no judgment, ever)
How Hey Jane works
You'll be supported every step of the way.
1
Consult
First answer a few questions at heyjane.com to confirm medical eligibility, and then talk with an experienced clinician to answer any questions about treatment.
2
Care at home
Safe
Same FDA-approved abortion pills you’d get in a clinic
Convenient
Connect with our clinical care team through phone, video, text, or chat
Affordable
Can be more affordable with insurance if services are covered under your plan
Get FDA-approved abortion pills quickly delivered to your door. They’ll arrive in an unmarked box to protect your privacy. 3
Connect
Our clinical care team is just a text, chat, phone call, or video call away we’re here if you need someone to talk to.
STI Testing and SHIP/Aetna Health Insurance A Guide to Coverage
Check Yourself & Protect Yourself:
Know your status.
Test preventatively before sex with a new partner; and post, after potential exposure. Use condoms and dental dams. If you are at higher risk of infection, talk to your medical provider about medications for PrEP (pre-exposure prophylaxis).
Information in this summary document is provided by the Insurance Office of USC Student Health. For detailed questions regarding plan benefits, including steps for filing claims, policyholders are directed to review the plan documents and verify additional details that are available. You may access your Aetna plan online (www. aetnastudenthealth.com) or you may call the number listed on your insurance card.
Under USC SHIP (Student Health Insurance Plan, provided through Aetna), sexually transmitted infection (STI) testing is covered under preventive screening and as also as part of clinical care diagnosis. Tiers 1 & 2 are 100% coverage, no deductible applies. [USC Student Health and other Keck Medicine of USC entities are Tier 1 providers.] Tier 3 is 50% coverage, deductible applies. Students enrolled in USC SHIP can receive unlimited STI screenings without patient cost share.
What this means for SHIP/Aetna policy members:
1)Routine screening STI testing that is recommended annually is covered, without cost to the patient. Tier designation of provider applies. [USC Student Health and other Keck Medicine of USC entities are Tier 1 providers.]
2) Additional frequency of testing as part of clinical care for potential exposure is covered, without cost to the patient, as this testing is part for diagnosis services (medical visit or consultation). Tier designation of provider applies. [USC Student Health and other Keck Medicine of USC entities are Tier 1 providers.] Exposure through unplanned unprotected sex, or as part of a prophylactic regimen for individuals in populations with higher risk of exposures, such as people on PrEP medications.
Related information: If you are getting together with a new partner or had sex without using a barrier (condom/dental dam), it’s recommended that you test to know your status. You can order the right tests for yourself in MySHR and head to the lab without a clinical interview with a medical provider. Check out our quick guide to STI testing, (https://bit.ly/uscselfdirectedtesting).
Note for students on all insurance plans:
•Under the Affordable Care Act (ACA), all insurance plans must cover HIV testing for everyone ages 15-65. Coverage for other STIs such as syphilis, chlamydia, and gonorrhea, may vary, but these tests are often part of your preventive care benefits.
Additional resources in LA County (including for partners who are non-students):
•AHF Los Angeles is a leading nonprofit that offers STI testing and access to treatment; testing services are at no cost to patients, locations, including mobile testing vans, are available throughout Los Angeles and at locations nationally. (https//ahf.org)
•Los Angeles County Dept. of Public Health provides an online pocket guide to free reproductive and sexual health hotlines and services. (https://pocketguidela.org)
GENDER AFFIRMING CARE
If you are transgender, non-binary or gender diverse, we understand the importance of getting quality health care in a safe and welcoming environment. The USC Gender-Affirming Care Program’s providers deliver expert, compassionate and equitable care for all.
We focus on understanding your unique medical needs and delivering the right health services when you need them. Our services include: affirming primary care and chronic disease management, genderaffirming surgical care, gynecologic care, hormone therapy, mental health care, occupational therapy, physical therapy, sexual health, STI testing/treatment, HIV care, PrEP, PEP, telemedicine, urologic services, and voice therapy.
Our surgeons are experienced in gender-affirming surgery (also referred to as transgender surgery by some patients), including chest procedures (top surgery), genital procedures (bottom surgery), facial procedures (including facial feminization/masculinization) and hysterectomies.
Laura B. Taylor, MD (she/her) Medical Director, USC Gender Affirming Care Program
Roberto Travieso, MD (he/him) Surgical Director, USC Gender Affirming Care Program
For more information or to speak with a patient navigator, call
or email
Please include your chosen name and pronouns, name on insurance, DOB, insurance plan name and the best phone number to reach you.
Live your best life
Sometimes your gender identity doesn’t exactly match the gender you were born with. That’s called “gender dysphoria.” We’re here to support you every step of the way on your journey to expressing your gender identity. That’s why we’ve added a variety of transgender services to some of our plans. We want to help you choose the care that's right for you.
Connecting you to care
Some of our plans offer transition assistance that will help you take care of your physical and behavioral health needs. We also offer benefits that will help you address your dailyliving needs after your transition. Your coverage for gender transition services depends on your health plan and on certain state and federal laws.
You may be able to get help with:
•Behavioral health services
•Hormone therapy and medications
•Surgical services
•Ongoing health and wellness support
We’re here for you
You can call Aetna® Member Services for assistance at 1-877- (TTY: 711). They can help you:
•Understand and access your benefits
•Get help with precertification for gender affirmation procedures
• Find the doctors and facilities that work best for you
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Get the care that’s right for you
Finding a provider
It’s important to find a provider who understands your unique health care needs.
You should feel comfortable with your provider so you can be honest and open with them and ask them any questions you have.
Getting the most from your plan
Behavioral health services
Your mental wellbeing is important, and we encourage everyone to visit a behavioral health provider. In fact, talking to a behavioral health provider before your gender affirmation surgery is a requirement for your transition planning. Before you can schedule a gender affirmation surgery, you will need:
•One letter from a behavioral health care provider for breast surgery
•Two letters from behavioral health care providers for genital surgery
Your p can help you find the right behavioral health provider and services for your needs. Or you can call Member Services and ask for a list of behavioral health providers in your area.
Hormone t herapy
Hormone therapy can be a way to affirm your gender. You should talk to your before starting hormone therapy. They’ll talk to you about any risks or side effects. And they'll help make sure you’re taking the right amount for your desired results.
Alcohol and tobacco use raises the risk of side effects when taking hormones. Ask your provider how much alcohol is safe for you and about ways to quit smoking, especially if you are considering surgery.
Gender affirmation surgery
If you decide to have a gender affirming surgery, we’ll be right here to help. You can call Member Services or ask your to help you find an appropriate surgeon. (They often are not local.) Then we’ll work with your surgeon to get all of the precertifications you need. While you’re getting ready for your surgery, it’s important to stay in shape — that means eating healthy and exercising regularly.
You may be covered for a variety of surgeries, including: • Breast reduction, removal or augmentation •Removal of reproductive organs •Creation of exterior sexual organs
You can find out which surgeries are covered or excluded and which services have limits by calling Member Services. The resources below will also give you more information about our gender affirmation policy and breast surgery providers.
•Aetna standard gender affirmation clinical policy •Breast reduction and augmentation surgery providers (PDF)
Gender support services
Depending on your plan, you may be covered for a variety of other services, including:
•Behavioral health services
•Hormone therapy
•Breast reduction, removal or augmentation
•Genital surgery
Staying healthy after your surgery
We’ll help you take care of yourself after your surgery. You should talk to your about safe sex and being screened for sexually transmitted diseases.
You’re also covered for preventive health services based on your birth anatomy, including screenings for:
• Breast cancer
•Cervical cancer
•Prostate cancer
Each benefits plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member’s benefits plan to determine if there are any applicable exclusions or other benefits limitations. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If there is a discrepancy between this policy and a member’s plan of benefits, the benefits plan will govern.
Get the support you need
As you begin your journey to transition your gender identity, know that we’re here to help, every step of the way. And that’s why we’ve added coverage for gender-affirming services to some of our plans. This will help you get the care that's right for you.
Connecting you to care
Some of our plans offer services and support that will help take care of your physical and behavioral health needs. We also offer benefits that help with daily living needs after your transition. Based
• Behavioral health services
• Hormone therapy and medications
• Surgical services
• Reproductive services
• Ongoing health and wellness support, and more
Create your care team
It’s important to find providers you’re comfortable with and who understand your unique needs. Keep in mind that your mental well-being is also a key part of your transition. You will have access to a transgender care personal navigator who has specialized training to provide you with dedicated support. They can also help you find doctors and explain your costs and benefits. Log in to your member website at Aetna.com or call us.
Know what’s covered
Your coverage for services depends on your health plan and certain state and federal laws. So be sure to check your benefits plan, refer to the resources below or call us for help.
• Aetna standard gender affirmation clinical policy
• Breast (top), genital (bottom) and facial gender affirming provider (PDF)
Each benefits plan defines which services are covered, which are excluded and which are subject to dollar caps or other limits. Members and their providers will need to consult the member’s benefits plan to determine if there are any exclusions or other benefits limitations applicable. Some plans exclude coverage for services or supplies that Aetna® considers medically necessary. If there is a discrepancy between this policy and a member’s plan of benefits, the benefits plan will govern.
