Except in emergencies, a referral from an on-campus Medical Services or Counseling and Psychological Services provider is required to utilize the benefits available under the Columbia Student Medical Insurance Plan for off-campus providers. Providers at Medical Services and Counseling and Psychological Services provide referrals after evaluation and treatment on campus has been completed and as the need for outside services is clinically indicated. Referrals are also required for urgent care provided outside of an emergency room (see below).
You don’t need separate referrals each time you see the same provider for an ongoing condition. Referrals for medical conditions will terminate on the last day of each plan year, August 31. We recommend scheduling an appointment with your Primary Care Provider to determine if a referral for continued treatment is indicated. Referrals for mental health conditions for off-campus counseling and psychiatric services are valid as long as you remain continuously insured by the Columbia 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 Columbia Health 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
- Services, including urgent care, require a referral for coverage under the Columbia Plan. In the event of an urgent medical need when Columbia Health is closed, you must contact the clinician-on-call at (212) 854-9797 for medical advice or to obtain a referral for an Urgent Care facility if it is indicated. Immediate medical treatment received at off-campus Urgent Care facilities is not covered without a referral obtained in advance of the visit; emergency room care is excluded from this requirement. In a medical emergency, advance consultation with a Columbia Health provider is not required.
A referral is not required under the following conditions, although your Columbia Health provider can assist you in ﬁnding appropriate services.
- Emergency medical conditions (students must return to Columbia Health 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 Plan's policy and the student may be responsible for a portion of the laboratory testing. No referral will be needed