Primary care referrals mean you’re not alone

Your primary care provider (PCP) helps you make important decisions and can coordinate your care with your entire healthcare team. As a Medicare Advantage member, your PCP will coordinate referrals when you see a specialist, have a test, and receive some other services. Members who have the Healthmate for Medicare (PPO) plan do not need referrals.

Some covered services do not require a referral, including*:

  • Mental health and substance use services
  • Emergency and urgent care services
  • Retail health clinics

Other services will require a referral, such as*:

  • Allergy office visit
  • Chiropractic office visit
  • Dermatology office visit
  • Hearing exam (routine)
  • Occupational therapy
  • Physical therapy
  • Podiatry office visit
  • Specialist office visit
  • Vision care visits (non-routine)

*This is not a complete list. For more important information regarding referrals, see your plan’s evidence of coverage. You can find it on our Plan Materials page.

How do I find a PCP?
Use our find a doctor tool. Search for a "PCP" near you.

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Call the Medicare Concierge team at (401) 277-2958 or 1-800-267-0439 (TTY: 711). Hours: Monday through Friday, 8:00 a.m. to 8:00 p.m.; Saturday, 8:00 a.m. to noon. (Open seven days a week, 8:00 a.m. to 8:00 p.m., October 1 - March 31.) You can use our automated answering system outside of these hours.

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Contact the Medicare Sales team at 1-800-505-BLUE (2583) (TTY: 711). Hours: Monday through Friday, 8:00 a.m. to 8:00 p.m. (Open seven days a week, 8:00 a.m. to 8:00 p.m., October 1 – March 31.) You can use our automated answering system outside of these hours.

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