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Referrals help your doctor manage your care

Referrals play an important role in helping your Primary Care Physician (PCP) or doctor manage your care and coordinate the different care you may need.1 If you need specialty care, your PCP or doctor refers you to a specialist.

Referrals ensure that you get the highest level of benefit coverage from your health plan. If your health plan requires referrals before you receive certain care, please know that:

  • You do not have to bring a paper copy of the referral to the “referred to” doctor or facility. That doctor or facility can see this information online.
  • You can ask your participating PCP or doctor to give you a copy of the referral confirmation or you can print a copy by signing in to Member Online Services.

1Not all plans require a PCP. Referrals are required for members enrolled in Horizon HMO plans. Referrals are required for members enrolled in Horizon POS plans to receive coverage at an in-network benefit level. Referrals are not valid for out-of-network services.

This article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.