NU-SHIP Referral Requirement

Sheridan Road in the fall

The Northwestern University Health Service (NUHS) and Counseling and Psychological Services (CAPS) serve as your primary care providers while you are in the Evanston / Chicago area. They should be your first stop in coordinating your medical and mental health care needs, and any referrals for outside services.* Please see the instructions for after-hours care when NUHS is closed.

Why do I Need a Referral?

The NU-SHIP is designed to work in coordination with campus health services. When NUHS and/or CAPS manages your healthcare needs, you benefit by:

  • Having a provider who can support your full medical / mental health history and coordinate appropriate care as needed
  • Minimizing out-of-pocket healthcare costs

Please note: because the NU-SHIP is an annual insurance plan, all referrals must be updated annually!

*Dependents are not eligible to use the services of the Northwestern University Health Service and therefore are not subject to the referral requirements and penalties.

What Happens if I Don’t Get a Referral?

You will be responsible for a $50 penalty, per condition (in addition to any plan co-pay or deductible which may apply), for any expenses you incur for which you did not obtain a referral from NUHS. A referral is required when services outside NUHS are provided in Cook and Lake Counties.

When Don't I Need a Referral?

Referrals from NUHS are not required in the following circumstances:

  • Medical care received when the student is outside Cook and Lake County boundaries
  • Obstetric and gynecological treatment
  • Pediatric care
  • Mammography
  • Maternity
  • Mental health and substance abuse
  • Treatment for an emergency medical condition
  • Preventive / Routine services (services considered preventive according to the Affordable Care Act and/or services rendered not to diagnose or treat an Accident or Sickness)

Preferred Provider Network

Aetna Student Health, the sponsor of the NU-SHIP, has an extensive Preferred Provider Network in the Evanston / Chicago area, as well as nationally.

To maximize your savings and reduce your out-of-pocket expenses, you are encouraged always to select a Preferred Provider; these providers have agreed to accept negotiated rates as payment for specific services, which reduces your costs.

If you are in need of a medical service or procedure that is covered under the NU-SHIP, but is not available from a Preferred Provider, you should contact Aetna Student Health’s Member Services at 877.626.2314 for assistance.  In this situation, Aetna may issue a pre-approval for you to obtain the service from a Non-Preferred Provider.  When a pre-approval is issued by Aetna, covered medical expenses are reimbursed at the Preferred Care level of benefits.

Click here to obtain a list of NU-SHIP Preferred Providers in your area.