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
- 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.