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Health Information

Medical care in the United States is extremely expensive. It is absolutely necessary that you and all family members have adequate health insurance. It is your responsibility to understand the way your insurance policy works, and how to access health care providers who will accept your insurance plan. It is easiest to understand this while you are healthy; do not wait until you are sick!

If you are a J-1 and J-2 Exchange visitor seeking guidance on J-1 health insurance requirements, please visit the J-1 Health Insurance page.

Affordable Care Act ("ObamaCare") Information

All international scholars and their dependents should be aware that depending how long they remain in the United States, they may become subject to the terms of the Affordable Care Act (ACA).

Affordable Care Act (ACA) provisions require that individuals be enrolled in ACA-compliant insurance plans or pay a tax penalty--the "Individual Shared Responsibility" provision--to the U.S. Internal Revenue Service (IRS). Whether individuals are subject to this mandate is determined by your tax status (NOT IMMIGRATION STATUS). If you are a non-resident alien for tax purposes, then you are not subject to this individual mandate. If you are a resident alien for tax purposes, however, then you must be enrolled in an ACA-compliant insurance to avoid an IRS penalty. Note, however, that tax laws updated in 2017 have suspended this IRS penalty. For those scholars who receive compensation from UC San Diego, your Glacier tax online enrollment process identifies your tax residency status--you should view the "Residency Status Start Date" indicated on the "Tax Summary Report" provided by the system upon completion. If you are paid in some way by UC San Diego and have not completed the online Glacier questionnaire, see your departmental administrator as soon as possible to complete this.

As a very general rule, scholars in J-1 status who are in the U.S. for no more than portions of two calendar years (for example, December 1, 2015 through November 30, 2016) are considered non-resident aliens for tax purposes. J-1 scholars who are here for more than portions of 2 calendar years and 183 days of the current year will be considered resident aliens beginning the third calendar year (for example, December 1, 2014 through November 30, 2016--the J-1 will become a resident alien for tax purposes on Jan 1, 2016). See "Determining Alien Tax Status" and follow instructions for the "Substantial Presence Test." 

All UC San Diego employee-provided insurance plans and the Garnett-Powers plans for Postdoctoral Scholars are ACA-compliant. The Garnett-Powers plans for visiting academics (not postdoctoral scholars) are not ACA compliant. If you are a Resident Alien for Tax purposes and have questions about your non-UCSD plan, you should contact the insurance plan administrators directly and confirm that your insurance plan is ACA-compliant.

If you are seeking to enroll in other insurance plans, note that nonimmigrants are allowed to enroll in marketplace insurance exchanges established by the ACA enactment (see list) and also the main marketplace website. Additional information can be found in the presentation given to J-1 Exchange Visitors at UC San Diego  in 2015 by the Legal Aid Society of San Diego.

All J-1 scholars will still be required to maintain insurance that meets the federal regulatory requirement for this nonimmigrant classification and the requirements imposed by the University of California, San Diego, regardless of your tax residency status.

Behavioral Health, Wellness, Counseling, and Support

Alert

If you are experiencing a crisis, please call a crisis hotline.
Postdoctoral scholars Paid Employees on a UC San Diego sponsored plan Unpaid Researchers, Scholars, and Visitors
  • Health Sciences
  • All Other (such as main campus/scripps): 
    • Faculty and Staff Assistance Program (FSAP) is available to Scholars and their family members (seen together with the Scholar). Family members may need to pay a nominal fee.
  • Enrollees of Gallagher (Garnett-Powers) plans (excluding postdocs):
    • Gallagher plans meet the minimum catastrophic health insurance coverage required by the department of state for J scholars; as such they do not typically include coverage for services such as routine checkups, vaccines, annual visits, behavioral health, etc. 
General Resources

Dental

Note

We encourage you to review the providers covered by the specific insurance to ensure there is one near your current residence or worksite.
Postdoctoral scholars Paid Employees  Scholars, Researchers, Visitors enrolled in Gallagher (Garnett Powers)
  • Coverage is not included with Basic, Standard or Platinum plan as coverage is meant to include catastrophic health coverage during visit to the U.S. Dental coverage is not required for the J program. A Supplemental Plan is available for an additional cost. 
  • You may also purchase your own coverage with other vendors 

Vision

Postdoctoral scholars Paid Employees 
  • Eligible for VSP Network through UCpath for those eligible for full UC San Diego benefits
Scholars, Researchers, Visitors enrolled in Gallagher (Garnett Powers)
  • Coverage is not included with Basic, Standard or Platinum plan as coverage is meant to include catastrophic health coverage during visit to the U.S. Vision coverage is not required for the J program. Additional coverage can be bundled with Dental insurance purchase through DPPO Ameritas.
  • You may also purchase your own coverage with other vendors

COBRA (Continuation of Benefits After Employment Ceases)

COBRA is a federal law that allows persons with employer-provided health insurance to elect to continue their health insurance coverage after their employment ceases at full premium cost to themselves plus a 2% administrative surcharge. To elect this coverage you should speak with your Human Resources Benefits representative to make sure that you meet all eligibility requirements and understand the process. This option is only available to persons employed by UC San Diego; those persons not employed by UC San Diego wanting to extend their health insurance beyond the end of their UC San Diego program should reach out directly to their plan sponsors to discuss their request.

Clinics and Referrals near UC San Diego

UC San Diego Clinics
The local clinics listed below will accept most U.S. insurance policies, but not all foreign policies. If you are covered by insurance from your home country, it may be necessary for you to pay the clinic directly and then be reimbursed by your insurance company.

La Jolla Family and Sports Medicine
9333 Genesee Avenue Suite 200
San Diego, CA 92121
(858) 657-8600
Internal Medicine Group- La Jolla
8939 Villa La Jolla Drive Suite 111
La Jolla, CA 92037
(858) 657-8000

Physician Referral Services
Listed below are physician referral services. Specify the type of physician needed and the most convenient area and they will refer someone (no fee for the referral). Hospital emergency room treatment is expensive and should ONLY be used in emergency situations.  Urgent care centers usually have more extensive hours than a general physician's office, and will be considerably less expensive than a hospital emergency room.  Note that referral services will not know your insurance plan; it is your responsibility to understand the coverage limits and procedures for accessing health care under your health insurance policy.

UC San Diego Healthcare Access
Excellent resource for referrals and information regarding
UC San Diego Medical Center physicians and services.
(800) 926-8273
http://health.ucsd.edu
San Diego County Medical Society
A physician-funded referral service.
(858) 565-8888
http://www.sdcms.org

COVID-19

Alert

UC San Diego Daily COVID-19 Dashboard: https://returntolearn.ucsd.edu/dashboard/index.htmlThere are COVID-19 policies from the Federal Government, State of California, San Diego County, and Return to Learn (UCSD). Please note that Return to Learn - UC San Diego may have more restrictive policy than other government agencies. Masking guidelines vary depending on location, vaccination status, etc. please carry a mask with you at all times to be ready to abide by the guidelines.
Daily Screening
The Daily Symptom Screener is no longer required, students and employees must still use the COVID-19 Symptom Screener for the following reasons:
  • If you are symptomatic and have been exposed to COVID-19
  • If you tested positive for COVID-19

COVID-19 Testing
Faculty, Staff, Researchers, and Scholars have access to no-cost asymptomatic test provided by UC San Diego. Testing can be conducted even if working remotely.
  • Active Directory (AD) credentials (username/password) are required to schedule test.
  • UC San Diego International Visitors without Active Directory credentials are eligible for no-cost asymptomatic testing through UC San Diego: email rtl@ucsd.edu (Return to Learn) with the following.
    • indicate you are an international visiting scholar, researcher, etc. without active directory credentials working on campus and in need of "Campus Community Member" testing.
    • You will be provided with a different link and a password to use.
      • Tips:
        • SSN: if you do not have one yet, write zeros (000-00-0000)
        • For insurance: if you have not signed up for insurance yet, select no insurance (UCSD is not going to bill you)
        • Who will pay: select someone else (UCSD is not going to bill you)
    • Please note that this feature will not allow you to use the vending machines for testing, but will allow you to schedule asymptomatic testing appointments at one of the various UC San Diego sites.

UC San Diego Health is offering family and community members COVID testing for $65 by appointment. Results usually provided within 48 hours. 

 

Note

Your Department Human Resources (HR) will be the best person for you to consult regarding COVID-19 protocols for your department, as the requirements may vary between UC San Diego areas such as Health Sciences and Main Campus.

COVID-19 Resources:

Flu Vaccine

The University of California System issued a system wide statement requiring flu vaccines for all UC San Diego Students, Faculty and Staff.

Faculty/Scholar options for getting a flu vaccine:

Faculty and Staff with Active Directory (AD) credentials can self schedule a flu vaccine appointment by going to https://flu.ucsd.edu/

Health Insurance Terms

Note

Gallagher (Garnett Powers) has also created an reference sheet with general health insurance terminology.

Basic medical coverage
The first level of insurance designed to cover expenses that exceed a small deductible (payable by the insured person). The basic medical benefit usually covers physicians’ fees, laboratory tests, prescription medicine, and hospital expenses. The basic medical benefit should be supplemented by a major medical benefit.

Coinsurance payment
The sharing of certain costs between the insurance company and the insured person, usually at the rate of 80 to 20 percent, respectively.

Coverage, or covered expenses
The medical expenses that will be paid by the insurance company.

Deductible
The initial medical expenses per diagnosis, per incident, or within a specific time period, paid by the insured person and not reimbursable by the insurance company.

Effective date
The date on which the insurance policy takes effect, usually the date the enrollment form and premium reach the administrator’s office. In some cases, group policies may be pre-dated to the first day of appointment.

Eligibility
Defines who may participate in the insurance program.

Emergency Room Services
Health care provided at a hospital emergency room; this is the most costly way to receive health care and should only be used in actual emergency situations.  Some insurance policies may not cover emergency room treatment if the situation is not an emergency, and emergency room services are extremely expensive.  Non-emergency situations should be handled through appointments with physicians or, if the situation is one that cannot wait, but is not life-threatening, at an Urgent Care Facility (see below).

Exclusions
Expenses not reimbursable by the insurance company.

Major medical coverage
The second level of insurance designed to cover those expenses that exceed the limits of the basic medical benefit. The major medical benefit usually pays 80-100% of the medical expenses up to a maximum amount.

Maternity coverage
Maternity coverage will often not cover any pregnancy that existed prior to becoming insured.

Medical evacuation
Coverage for transportation of the insured person back to the home country as recommended by the attending physician for medical reasons.

Participant
The individual covered by the policy.

Pre-existing conditions
Conditions existing prior to the effective date of the policy.

Premium
The non-refundable cost of the insurance.

Repatriation of Remains
In case of death, the cost of preparing and transporting the remains of the person to the home country. While this is rarely used it is important in maintaining your non-immigrant status.

Underwriter
The insurance company.

Urgent Care Facility
Facilities that provide health care without requiring an appointment.  Such facilities are typically open during weekends and evenings in addition to daytime, and are ideal for treating situations that are not life-threatening, but do need to be addressed without waiting to make an appointment with a physician.  Services are much more cost-effective than those provided in an emergency room visit (see above), and will ultimately cost you less than care provided at an emergency room.

UC San Diego smoke-free campus

no smoking

UC San Diego has a smoke-free policy (PPM 270-7) that extends a non-smoking zone from 25 feet away from a doorway, entryway, operable window or ventilation intake duct of any facility. Also, San Diego Health Sciences has prohibited smoking in all its buildings and outdoor areas. 

All UC campuses will be tobacco-free by 2014; UC San Diego will be SMOKE-FREE AS OF SEPTEMBER 1st, 2013. The new policy prohibits the smoking and chewing of tobacco, as well as the sale of tobacco products, and aligns with practices already in place at UC medical centers and other universities. See the UC San Diego Fact Sheet and visit http://smokefree.ucsd.edu (coming soon!) for more information.