Get News & Updates Directly To Your Inbox
Get News & Updates Directly To Your Inbox
Find A Doctor Or Hospital In Your Network.
Looking to see a specialist aside from your primary care physician like Vanessa? Not to worry! Robert answers Vanessa’s question about which plan needs a referral to see a specialist. Learn more about the referral process.
Find more Health Care One-to-One videos.
VANESSA: Hi. I'm Vanessa and I'm meeting with the Blue Cross and Blue Shield customer advocate to find out: Do I need a referral to see a specialist? I hurt my knee playing volleyball and my doctor says I need to see a specialist. Do I need a referral?
BCBS ADVOCATE: I'm sorry to hear that, Vanessa. Do you have an HMO or PPO plan?
VANESSA: An HMO.
BCBS ADVOCATE: In that case, yes. After you've seen the primary care doctor he or she will need to provide you with the referral to a new specialist.
VANESSA: So is that complicated?
BCBS ADVOCATE: It's really not. Your doctor will give you the name of a specialist in your health plan's network and complete the referral then all you need to do is call and set up an appointment with the specialist.
VANESSA: I may be switching to a PPO plan soon. Will I need a referral with that plan?
BCBS ADVOCATE: With a PPO plan, you don't need a referral. The main thing to remember is that choosing a doctor in your network will normally cost you less even with the PPO.
VANESSA: That's so good to know. Thanks so much for all your help.
BCBS ADVOCATE: You're welcome.
SPEAKER: For more information call the number on your member ID card or visit our website at BCBSNM.com.
Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation,
a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
© Copyright 2024 Health Care Service Corporation. All Rights Reserved.
Telligent is an operating division of Verint Americas, Inc., an independent company that provides and hosts an online community platform for blogging and access to social media for Blue Cross and Blue Shield of New Mexico.
File is in portable document format (PDF). To view this file, you may need to install a PDF reader program. Most PDF readers are a free download. One option is Adobe® Reader® which has a built-in screen reader. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com.
You are leaving this website/app ("site"). This new site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. Some sites may require you to agree to their terms of use and privacy policy.
Powered by Telligent