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Service Authorizations and Referrals

Permission to see providers is called a "referral" and permission to receive services is called an "authorization." If you need either type of permission, your Primary Care Physician (PCP) will request it for you. If you are referred to a Specialist and he or she believes you need services requiring authorization, he or she will request it for you. Some providers and certain services may not require permission from your PCP.

Authorization and referral requirements only apply to services covered by your plan. For a detailed explanation of what services are covered by your plan and how to receive them, please reference your plan’s Evidence of Coverage (EOC).

 
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