Your primary care physician is usually your first point of contact for your health care.
In an emergency, you should seek care at the nearest medical facility. When appropriate, we encourage you to call 911.
If you need the care of a specialist, such as a dermatologist or a cardiologist, it's your primary care physician's role to refer you.
These are some of the services your primary care physician may provide:
- Coordinates your medical care, including referrals to specialists
- Orders lab tests, X-rays and other medical tests
- Arranges your admission to a hospital or skilled nursing facility
- Focuses on improving your health through preventive care services, including periodic exams, immunizations and well-child and well-baby care
- At your request, assists you in obtaining approval for mental health and substance abuse services
- Assists you in applying for hospice care
There is a benefit that enables you to go directly to a specialist within your doctor's IPA or medical group without a referral. Read about the Access+ Specialist option in "Specialist Care".
Please check your Evidence of Coverage (EOC) or Certificate of Insurance (COI) for specific details about your plan.