Referrals and preapprovals
Referrals
Your primary care provider (PCP) can take care of many of your needs, but you may need care from another type of provider. If you do, your PCP may send you to a specialist. This is called a referral.
If you want to go to a doctor who isn’t your PCP, talk to your PCP first. If needed, he or she will refer you to a specialist in your plan.
Preapprovals
You may need preapproval for certain services. Preapproval is when your doctor asks us to approve a service before you receive it. Your PCP will work with us to get the approval you need.
You don’t need preapproval for these services:
- Emergency care
- Post-stabilization services (when you get out of the ER)
- Urgent care
- Family planning services
- Certain behavioral health and substance use disorder services (ask your doctor if preapproval is needed)
Have questions?
We’re here to help!
Call us at
1-844-405-4295 (TTY 711).
Additional benefit details are also available in your member handbook.