Columbia University Health Services

A referral from Primary Care Medical Services (PCMS) or Counseling and Psychological Services (CPS) is required to utilize the benefits available under the Columbia Student Medical Insurance Plan for off-campus services, except in emergencies. 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 must obtain a referral from a Health Services provider prior to receiving any off-campus medical, counseling or psychiatric services. Services rendered without an appropriate referral will not be covered under the Columbia Student Medical Insurance Plan
• We have simplified the referral requirements so that you do not need separate referrals, and there are no time or visit limits for care provided by the same provider for an ongoing condition as long as you are continuously insured. You must have one referral for each condition being treated outside PCMS and/or CPS
• When you are not in New York City during semester breaks, holidays or the summer, and you are injured or become ill, please call your Health Services clinician so that he or she can determine appropriate treatment. You will be eligible for coverage as long as you get a referral from your on-campus provider in advance of receiving services
• Even with a referral, you will be responsible for a copay and possible coinsurance charges when seeing an off-campus provider
• Advance consultation with a Health Services clinician is not required in a true medical emergency

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
  
• Continuing treatment for a condition evaluated in a prior year under the Columbia Student Medical Insurance Plan for which a referral was obtained previously
  
• 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