Seeing specialists
What's a specialist?
Although you may have a primary care doctor or other primary health care provider (PCP) who treats your regularly, he or she might recommend that you visit a specialist. Specialists have advanced training in one or more specific areas of medicine (ie. cardiology, neurology, plastic surgery, etc.), and are commonly used to confirm a diagnosis and/or to plan and execute a special treatment or procedure that your PCP can't provide. LINK Read more about using primary care physicians.
You don't need a referral
Priority Health doesn't require that you get a referral from your PCP to see a specialist. However, some specialists will require a referral from your PCP before they will agree to see you, but Priority Health does not need to approve referrals.
HMO and EPO members: It's always a good idea to let your PCP know what other doctors you're seeing so they can better coordinate your care. Use the online Find a Doctor directory to find network specialists and hospitals. Note: While it's not a Priority Health requirement, some specialists still require a referral from your PCP before they will see you.
POS members: You may see a network specialist at any time but some specialists may require a referral from your PCP. You may see an out-of-network specialist any time, but the alternate benefit level copay and costs will apply.
PPO and MyPriority members: You do not need a referral from a primary care physician to visit a specialist. Just remember that if you visit a non-network specialist, the alternate benefit level will apply, even if a network doctor refers you. And make sure your primary care doctor (PCP) knows about any treatments or drugs you are choosing.
Seeing a chiropractor
Most plans cover chiropractic visits, but only for spinal manipulation. For more information, see your coverage documents.
