PRE-AUTHORIZATION REQUIREMENTS FOR OFF-CAMPUS CARE
When You Need Pre-Authorization--
The Princeton University Student Health Plan (SHP) requires that students initiate care at University Health Services (UHS) before being referred for off-campus medical care except for emergency illnesses or injuries during the plan year (September 1st through August 31st).
The SHP requires that UHS provide pre-authorization every 12 months for off-campus medical care. If you have been referred to an off-campus community provider by a UHS clinician during the 2013-14 plan year, you will need to contact UHS to see if you need an updated pre-authorization if you plan to continue with any ongoing medical services in the upcoming plan year which starts September 1, 2014. For example, if you received pre-authorization from a UHS clinician to see an off-campus specialist in November of 2013, you will need to secure an updated pre-authorization in November of 2014. If you do not remember the last time you received pre-authorization for off-campus services, please contact Aetna Student Health directly at: 1-877-437-6511. If you find that your pre-authorization has expired or is expiring in the near future, please be sure to call UHS to make arrangements for securing your pre-authorization at 1-609-258-3141. Care rendered without pre-authorization by UHS, will not be covered by the SHP.
You Do Not Need Pre-Authorization If--
- You have a life threatening emergency illness or injury and require hospitalization or emergency room services.
- You choose to use your $125 preventative dental visit.
- You are a dependent under the age of 16.
- During published Princeton University break periods (e.g., fall recess, spring recess, and summer).
- For mental health services with an established off-campus mental health provider.
- You are a student who maintains in absentia status and are not within a reasonable proximity to the University (i.e., outside Mercer, Middlesex and Somerset Counties in NJ and Bucks County in PA).
- UHS (McCosh Health Center) is closed.
We do ask that you contact UHS prior to receiving any elective surgery procedures during recess periods or over the summer so that your medical chart can be updated. Enrollees needing pre-authorization for medical care should contact UHS at 1-609-258-3141.
Enrollees are responsible for becoming familiar with all SHP benefits, limitations, and exclusions. Students should contact Aetna Student Healh at: 1-877-437-6511 or www.aetnastudenthealth.com for more information regarding the plan or for claim assistance.