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Referrals and Insurance

It is your responsibility to cover the costs for your private care, but most insurance plans have some form of benefit for inpatient, outpatient, or assessment services. Sometimes you pay nothing for your care, sometimes you pay part of the cost and your insurance company pays the rest. Sometimes your insurance company will pay different benefits if you see an "in-network" provider than if you see a provider who is "out-of-network". Every plan is different, and it is up to you to determine what your coverage is. It is your responsibility to obtain the information you need and make decisions about your own insurance and finances.

With the student health insurance plan through CareFirst, you will be covered from August 1, 2019 until July 31, 2020. If you intend to keep the AU plan, you will be able to create an account and access your ID card beginning August 1, 2019. If you choose to waive out of this plan, you will need to complete your waiver by visiting https://www.carefirst.com/au/


Your benefits include doctor and specialist visits, hospital and emergency care, prescriptions, mental health visits and more. The annual cost of the health plan, $1,890, will be charged to your student account.


If you have any questions about your plan, please call CareFirst at 844-898-3332.
 

If you have the AU Student Health Insurance Plan

Who is my insurance company?
If you have chosen to participate in the AU Student Health Insurance Plan, you are insured by CareFirst.

Who is considered an in-network provider?
To learn more about your insurance plan and who is covered by this plan, please visit: http://www.american.edu/ocl/healthcenter/About-Student-Health-Insurance-Plan.cfm and https://www.carefirst.com/au/

Will I have to pay a deductible?
This can depend on the type of care needed and the specific provider you choose to see. To learn more about your insurance plan and deductibles, please view the AU Benefits Summary.

How do I find an off-campus provider?
You have three options to find an in-network provider.

1) Visit the CareFirst website, where you can create an account and search for providers, or contact CareFirst by phone at 844-898-3332.

2) Call the AU Counseling Center or come to our Urgent Care Drop In Hours (M-F, 2-4pm). After completing some brief paperwork, you can meet with a clinician during these hours who can provide information about referral resources both in- and out-of-network providers.

3) Call the main number at the AU Counseling Center (202-885-3500) to schedule an Initial Consultation appointment. This last option can be used if you would like to meet with a clinician for a more in-depth assessment of your mental health needs and assistance with the referral process.

You may also find more information about this process on our ‘referrals to private care’ webpage, located here: https://www.american.edu/ocl/counseling/referrals-to-private-care.cfm)

Do I have to come to the Counseling Center before I can see a provider in the Community?
No. There is no insurance referral/paperwork requirement that necessitates obtaining a referral from the Counseling Center before you access your mental health benefits through CareFirst, and you are welcome to use the options listed above to find a provider on your own. If you would like assistance with finding a provider in the community, however, you are welcome to speak with one of our clinicians during Urgent Care Drop-In Hours (M-F, 2-4pm), or make an Initial Consultation appointment to speak with a clinician.

How will I know what my mental health benefits are and whether my claims to CareFirst will be paid?
A referral to a provider from the AU Counseling Center does not guarantee that the private services you receive will be covered by your plan or that a claim for those services will be paid. You are responsible for reading your plan carefully and negotiating directly with your provider and with CareFirst about your coverage and claims for private services.

What if I want to see someone who does not accept our insurance?
This decision is up to you—and if someone else is helping you to pay for services, this is a discussion to have with them, as well. The student health insurance plan through CareFirst does include out-of-network benefits—typically when using an out-of-network provider, you would have to pay up front for services, then submit paperwork given to you by your provider for potential reimbursement (although sometimes providers may be able to submit the claim on your behalf). To learn more about your insurance plan and benefits, please visit: https://www.carefirst.com/au/.

How do I arrange for my mental health bills to be paid?
If your private provider is an In-Network Provider, they are required to submit your bill/claim directly to the insurance company. Simply show your provider your identification card and they will submit the claim for you. If your provider is an Out-of-Network Provider, as mentioned above, it is up to your provider whether they will submit a claim or require that you do so. If your provider requires you to submit a claim, you can do so by registering or logging into your CareFirst My Account page here: https://member.carefirst.com/mos/#/login. Keep in mind that the cost of most visits is shared between you and the insurer--you will pay a part of the provider's fees and the insurer will pay a part. See your plan for details about your coverage and you may contact CareFirst with any questions at 844-898-3332.

I still have questions –who do I contact?
Please see below for contact information.

CONTACT INFORMATION
To find a list of mental health providers that are in network go to: https://www.carefirst.com/au/ and register or log in to the My Account page here: https://member.carefirst.com/mos/#/login.

To ask questions about your coverage or claims, contact CareFirst at 844-898-3332.


To write to CareFirst directly with a quality of care or service concern, you can:
Email them at quality.care.complaints@carefirst.com


Fax a written complaint to 301-470-5866


Write to CareFirst Quality of Care Department, P.O. Box 17636, Baltimore, MD 21297.

To ask questions about your student health insurance status:
Insurance Office, AU Student Health Center
(202) 885-3380
www.american.edu/ocl/healthcenter

To express concerns about your off-campus care, or obtain a referral to another provider:
AU Counseling Center
Mary Graydon Center 214
(202) 885-3500
www.american.edu/ocl/counseling

If you have a non-AU Insurance Plan

A formal referral from the Counseling Center is generally not required to use mental health or assessment benefits from non-AU insurance plans. Your non-AU insurance plan may have their own referral requirements, however. If you already know you want private care, you can work directly with your insurance plan to locate a provider and arrange for benefits. Otherwise, you can "drop by" Urgent Care (M-F, 2-4pm)or make an appointment with a Counseling Center clinician to discuss your particular situation and obtain guidance with regard to locating an appropriate off-campus provider.

To make an appointment with a Counseling Center clinician contact:
AU Counseling Center
Mary Graydon Center 214
(202) 885-3500
www.american.edu/ocl/counseling

To locate the names and contact information of your plan's in-network providers or to learn about your specific insurance plan you may contact your insurance company directly.