My insurance requires a referral in order to see an Alma provider in-network. Why?
Certain health insurance plans require a referral from a primary care physician (i.e., PCP) in order for care to be covered in-network. The most common situation where this happens is with Aetna student health plans. To receive off-campus mental health services through Alma that are covered by your insurance, the Student Health Center will need to submit a referral.
How can I request a referral?
To request a referral, you can contact your PCP or Student Health Center (if you have a student health plan). Tell your PCP or Student Health Center that you need a referral because you are seeking mental-health services that require a referral from a PCP, or that you will be seeking mental-health services off-campus and need a referral to receive in-network coverage for your care.
If you are not on a student health plan and also do not have a PCP, please contact your insurance carrier regarding referrals and they will help you to better understand your options for next steps.
How will I know if I need a referral to see an Alma provider?
It is important that you understand the details of your in-network benefits, including whether your plan requires a referral. If you aren’t sure about your coverage, we recommend reaching out to your insurance company directly. A support phone number or website is typically listed on the insurance ID card.
If our eligibility team reviews your insurance details and finds that your plan requires a referral, you will temporarily be marked as ineligible and you will receive an email asking that you contact your insurance carrier to request a referral.
Once your referral is confirmed by your PCP or your Student Health Center, please let our team know by clicking the Help button in the bottom right corner of the Support Center.
Does my referral expire?
Health insurance plans have different requirements for referral renewal. Please call your insurance to learn more about your plan’s referral renewal requirements.
Do I need a referral for any other services under my plan?
If a referral is required for mental health services, you may need a referral for other services through your plan as well. Contact your insurance company for details about what other types of services require a referral.