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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.  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) include one plan that is ACA compliant and two that are not.  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.

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

Health Insurance Terms

Click here to download a presentation on important health insurance terms (Insurance 101).

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.

Counseling and Support

The UC San Diego Faculty and Staff Assistance Program (FSAP) is a confidential service designed to help all campus employees, campus affiliates, and members of their immediate family resolve concerns that may be affecting personal well-being and/or job performance.

Services include:

  • One-on-one information, support, and counseling
  • Departmental behavioral consultation assistance
  • Coordinating counseling services and activities, as well as directing faculty and staff to outside resources
  • Educational workshops and support groups on a variety of topics

See their website to schedule an appointment or find additional resources. 

Contact Information

Phone (858) 534-5523

Address Torrey Pines Center South Suite 406, 10280 N. Torrey Pines Road

Note: The confidentiality of email cannot be guaranteed. The most confidential way to make an appointment is by phone.

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.