How referrals work when you’re on Medicare

A doctor talking to a senior patient in his office

You have a regular doctor you see for most of your health issues. But every once in a while, something comes up and you have to see a specialist. It’s good to know that getting to see the doctor you want is easier than you might think! With Original Medicare, you don’t need a referral.

Your Medicare Part B covers medically necessary doctor services, including outpatient services, certain inpatient services, and covered preventive services. You can visit many different types of health care providers because there is no network. Some of your options include:

  • Doctor of Medicine (MD)
  • Doctor of Osteopathic Medicine (DO)
  • In some cases: dentist, podiatrist, optometrist, chiropractor
  • Physician assistants
  • Nurse practitioners
  • Clinical nurse specialists
  • Clinical social workers
  • Physical therapists
  • Occupational therapists
  • Speech language pathologists
  • Clinical psychologists

Before you signed up for Medicare, you may have had a health plan that required a referral to see a specialist. Many health plans work that way, including most Medicare Advantage Health Maintenance Organization (HMO) plans, but Original Medicare does not.

With Original Medicare, no referrals are needed. You have access to any health care provider who has accepted Medicare assignment, so you can go right ahead and make your appointment with the provider you need!

Find out more about how Medicare works on our website, including when to sign up, how to prepare, and more.

©2019 Wisconsin Physicians Service Insurance Company. All rights reserved. JO15250 34361-100-1911

Leave a Reply

Your email address will not be published. Required fields are marked *

gtag('config', 'UA-118572759-1');