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Members

Referrals

When your Primary Care Practitioner (PCP) sends you to see a specialist, this is called a "referral." In most cases, your PCP must give you a referral to see a specialist. Always check with your PCP before going to see a specialist.

Self-Referrals

Some services do not require a referral. Some services that do NOT need a referral or prior authorization are:

  • Prenatal visits
  • Routine obstetric (OB) care
  • Routine gynecological (GYN) care
  • Routine mammograms, with a prescription
  • Routine dental services
  • Routine eye exams
  • Tobacco cessation counseling sessions
  • First visit with a chiropractor

Please check the Member Handbook or call Member Services at 1-800-521-6860 for more information.

Routine obstetric (OB) care and gynecological (GYN) care do NOT need a referral or prior authorization
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