How do I get referrals?

Click here to find referrals to healthcare providers in your area. Remember to make sure that any healthcare provider you select is in your health plan’s provider network.

What if you have a condition that requires the expertise of a specialist?

If you need to see a specialist you should start by consulting your primary care provider. Many health plans require a referral from your PCP before you can see another healthcare professional (except in the case of an emergency). This is especially common with HMOs. It’s important to know that some plans may not cover the cost of seeing a specialist if you do not first get a referral from your primary care provider.

***Note that a referral is not required for women seeking routine gynecological services, like screenings, Pap tests, obstetric care and annual check-ups from an in-network obstetrician or gynecologist (OB/GYN)***

Some plans will allow you to see any healthcare provider without a prior referral (this is sometimes called “self-referral”). However, be sure to check with your specific plan to see the rules surrounding referrals in and out-of-network.