The need for referrals can vary by plan type and type of service. Tests that may not need a referral or authorization, may still require an order from a physician. Details for your plan can be found on the Benefit Description tab.

Most preventive screenings are included in your plan at no additional cost.* If a service/procedure is ordered due to signs and/or symptoms, to check on an existing issue or to diagnose a health concern, cost share may apply.

Check your Benefit Description for more details.

*Under certain conditions, costs may apply.

With the Find a Doctor & Estimate Costs tool, you can search for your provider and see their tier. View the Find a Doctor & Estimate Costs tool. When logged into the Find a Doctor tool, results will populate according to your plan.

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 England^SM 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.

Most plans cover recommended preventive and travel immunizations without cost share.* This includes but is not limited to: flu shots, travel immunizations, shingles (Shingrix) and meningococcal vaccine.

Members can get their immunizations from an in-network provider or at an outpatient clinic. Members with pharmacy benefits with us may also be able to receive immunizations at retail pharmacy locations affiliated with Express Scripts®′ that offer vaccines.

*Under certain conditions, costs may apply.

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Chiropractic coverage depends on your plan. To view your Chiropractor Services benefits and limitations. Click here. (link to Chiropractics benefit.)

Chiropractic coverage depends on your plan. To view your Chiropractor Services benefits and limitations. Click here. (link to Chiropractics benefit.)