Health Insurance Basics
What is a health insurance referral?
A health insurance referral is a recommendation from your primary care physician to see a specialist. HMO plans typically require a referral from your PCP before seeing a specialist. PPO and EPO plans typically do not require referrals. Without a required referral, the plan may not cover the specialist visit.
Key Points
- Referral: PCP recommendation to see a specialist
- HMO plans: typically require referral from PCP
- PPO and EPO plans: typically do not require referrals
- Without required referral: plan may not cover specialist visit
- An independent agent can help you find plans with or without referral requirements