All HMO Blue® and HMO Blue New EnglandSM members must get a PCP referral before seeing a specialist. Because your PCP knows your history and health care needs, he or she is best qualified to help you decide whether a specialist is needed. To determine your cost share for these services, visit (link to costs and benefits table).
Blue Choice® and Blue Choice New EnglandSM members have the option to self-refer for covered services but may incur a higher out-of-pocket cost.
Members on PPO plans do not require a referral to see a specialist.
To determine your cost share for these services, visit (link to costs and benefits table).