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Do I Need a Referral to See a Psychiatric Provider With Aetna?
Do you need a referral?
The answer depends on your specific Aetna plan.
Some plans allow members to seek specialty care directly, while other plan designs may have referral or authorization requirements.
Because Aetna offers different plan types and employer-specific benefits, the safest approach is to check your individual plan.
What should you check?
Look at your Aetna member card and plan information, then ask:
- Do I need a referral for outpatient mental-health services?
- Is Meaningful Psychiatry in-network for my plan?
- Is the specific provider I want to see in-network?
- Are telehealth psychiatric visits covered?
- Do I need prior authorization?
The number on the back of your insurance card is the best place to confirm your individual requirements.
Referral vs. prior authorization
These terms are easy to confuse.
A referral generally means your primary-care provider directs you to another healthcare professional.
Prior authorization generally means your insurance company requires approval before certain services, treatments, or medications are covered under your plan.
They are not the same thing.
What if I do need a referral?
If your plan requires one, contact your primary-care provider and ask what information they need to send the referral.
You can also ask Aetna whether there are any specific requirements regarding the provider, service, or number of visits.
What if I don’t need one?
You can contact Meaningful Psychiatry directly to ask about availability and the next steps for starting care.
A useful resource for primary-care providers
If you are a primary-care practice and regularly encounter patients who need psychiatric services, establishing a referral relationship with a psychiatric practice can make the process easier for both your team and your patients.
Meaningful Psychiatry is interested in connecting with Washington primary-care practices and other healthcare professionals who may need a psychiatric referral resource.
Start with your insurance card
The quickest way to determine whether you need a referral is to contact Aetna using the information on your member card.
You can then contact Meaningful Psychiatry about current availability.
Call: 425-272-5931
Questions?
Send us a message! We’re happy to answer any questions you may have.