How Referrals Work

When your primary care provider determines that you need specialized care, he or she refers (or sends) you to a specialist. A specialist is a doctor, such as a cardiologist, dermatologist, or surgeon, who has extensive training and experience in one area of medicine. From the referral, the specialist can see:

• Who sent you for care
• Why you were referred
• With whom to follow up to coordinate your care

When do I need a referral?

If you have an HMO plan, you must get a referral before you see a specialist in your network. Otherwise you may be responsible for the cost of the visit.

Even if you're not an HMO member, it's still a good idea to get a referral. Your primary care provider knows your history and overall health, so you can be confident that you're getting the right care, at the right time, with the right doctor.

For more information, see our Frequently Asked Questions.