Important: Referrals for treatment of off-campus “medical” conditions need to be updated each plan year by your Primary Care Medical Services Provider. Referrals for off-campus counseling and psychiatric services are valid as long as you remain continuously insured by the Aetna Student Health Plan
Except in emergencies, a referral from an on-campus Primary Care Medical Services (PCMS) or Counseling and Psychological Services (CPS) provider is required to utilize the benefits available under the Columbia Student Medical Insurance Plan for off-campus providers. Providers at PCMS and CPS give referrals after evaluation and treatment on campus has been completed and as the need for outside services is clinically indicated.
- You must obtain a referral from a Health Services provider prior to receiving any off-campus medical, counseling or psychiatric services. You don’t need separate referrals to see the same provider for an ongoing condition established in the same plan year. Referrals for medical conditions need to be updated each plan year by your PCMS provider. Referrals for off-campus counseling and psychiatric services are valid as long as you remain continuously insured by the Aetna Student Health Plan
- If you are injured or become ill while traveling or spending an extended time away from Columbia, you will need to call and speak with your Health Services provider to determine what kind of treatment is appropriate.
- When you are not in New York City (during semester breaks, holidays), you will be covered for Primary Care, as well as other services, from the Aetna network of providers. You must get a referral from your on-campus provider in advance
- Even with a referral, you will be responsible for a copay and possible additional charges when seeing an off-campus provider
- In a medical emergency, advance consultation with a Health Services provider is not required.
A referral is not required under the following conditions, although your Health Services clinician can assist you in finding appropriate services.
- Emergency medical conditions (students must return to Health Services for necessary follow-up care)
- Pre-natal and obstetrical care
- Elective termination of pregnancy
- For women age 35-40, one baseline mammogram; one per year thereafter for women age 40 and older. Coverage may be provided more frequently if recommended by a physician for a covered person who has a prior history of breast cancer or who has a first degree relative with a prior history of breast cancer
- One annual routine Pap smear screening and office visit; Pap smear screenings and women’s health visits are available on campus, where a student pays no copay or deductible. If additional medically appropriate testing is performed as part of an off-campus annual Pap smear screening office visit, benefits for the testing will be payable in accordance with the policy and no referral will be needed
