Do I need a referral from my PCP to see a specialist? Will I have a co-pay?

Member for

3 years 4 months
Submitted by Linda.SimmonsBarrows on
HMO plans, like HMO Blue® and HMO Blue New England,SM require a PCP referral before seeing a specialist. Because your PCP knows your history and health care needs, they are best qualified to help you decide whether a specialist is needed.

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, click the Costs tab.