Medicare plans

Referrals from your PCP

Your PCP can handle most routine health care needs. If you need to see a network specialist or other network provider, you may need to get a referral from your PCP. Your PCP will make a referral based on your health situation. They may or may not refer you to a particular specialist in this directory who you want to see. Generally, your PCP will provide follow-up care, as needed. Please see the Evidence of Coverage for information about access to specialists. This directory provides a list of skilled nursing facilities for all networks. Contact your PCP for a referral to a network skilled nursing facility. The “network providers” listed in this directory have agreed to provide you with your health care coverage. However, some services may require a referral. If you have been going to one network provider, you are not required to continue going to that same provider. Check your Evidence of Coverage to make sure your plan includes additional benefits or that you've signed up for optional supplemental riders before making appointments for dental, vision or hearing services.

If you don’t have your copy of the Provider Directory, you can request a copy from Customer Service.

Tiers in primary care providers listing

Your plan’s network Primary Care Providers are grouped into two tiers. Depending on the tier your provider is in, your copay may vary for some covered plan services. You will generally pay the lowest copays with a Tier 1 provider. See your Evidence of Coverage (EOC) for more information.


Please call your provider's office or your Medicaid managed care plan to confirm the provider's enrollment or availability and participation in the Medicaid program.