Columbia University Health Services

Except in emergencies, a referral from an on-campus Primary Care Medical Services (PCMS) or Counseling and Psychological Services (CPS) provider is required in order to utilize the benefits available under the Columbia Student Medical Insurance Plan for off-campus services. Providers at PCMS and CPS provide referrals after evaluation and treatment on-campus has been completed and as the need for outside services is clinically indicated.

• 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 PCP 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 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 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 consulting provider.
• In a medical emergency, advance consultation with a Health Services provider is not required.

A referral is NOT required under the following conditions, though your Health Services provider 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.
• Dependents.
• For women 35-40: one baseline mammogram; one per year thereafter for women age 40 and older. Coverage will be provided more frequently if recommended by a clinician 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.
• Continuing treatment for a condition established in a prior year under the Columbia Student Medical Insurance Plan even if there is a gap between services.
• One annual routine Pap smear screening and office visit; Pap smear screenings and women’s health care visits are available on campus where a student pays no copay or deductible and all associated laboratory tests are covered. If additional appropriate testing is performed as part of an off-campus annual office visit, benefits for the testing will be payable in accordance with the Policy and the student may be responsible for a portion of the laboratory testing. No referral will be needed.
• The following services received at Morningside Dental Associates:
• emergency treatment of accidental injury to sound, natural teeth
• non-emergency treatment of accidental injury to sound, natural teeth
• extraction of impacted wisdom teeth
• treatment of dental abscesses