2025 Referral List

Do I need referrals with my plan?

PPO plan members: No referrals needed.
HMO plan members in Florida, Illinois, or Texas: You'll need referrals for certain specialists — check the lists below to see which ones.
HMO plan members in all other states: No referrals needed.

If your plan requires referrals and you have an Advocate Physician Partners (APP) primary care provider, APP will manage your referrals.

HMO plans in Florida, Illinois, or Texas

You need a referral for:

A
Allergist (Immunologist)

C
Cardiac electrophysiologist

Cardiologist

Cardiovascular surgeon

Colon and rectal surgeon

D
Dermatologist (Florida members: only for visit 6 and beyond)

Endocrinologist (not required for C-SNP plans in Texas)

ENT (Ear, nose, and throat specialist)

G
Gastroenterologist

General surgeon

Genetic counselor

Gynecologic oncologist

H
Hand surgeon

Hematologist

Hepatologist

Hospice and palliative medicine specialist

I
Infectious disease specialist

Interventional cardiologist

M
Medical geneticist

N
Nephrologist (not required for C-SNP plans in Texas)

Neurological surgeon

Neurologist

Oncologist

Oral surgeon (Maxillofacial surgeon)

Orthopedic surgeon

Otolaryngologist (Ear, nose, and throat specialist)

P
Pain management specialist

Physiatrist

Plastic surgeon

Pulmonologist

R
Radiation oncologist

Reproductive endocrinologist

Rheumatologist

S
Sleep disorders specialist

Spinal cord injury specialist

Sports medicine specialist

Surgeon

T
Thoracic surgeon

U
Urologist

V
Vascular surgeon

You don't need a referral for:

A
Acupuncturist

Addiction psychiatrist

Anesthesiologist

Audiologist

Certified diabetes educator (CDE)

Certified nurse-midwife

Certified nursing assistant (CNA)

Certified professional midwife

Certified registered nurse anesthetist (CRNA)

Chiropractor

Critical care medicine specialist

D
Dentist

Dialysis

E
Emergency medicine specialist

F
Family medicine physician

Forensic pathologist

G
General practitioner

Geriatric medicine specialist

Gynecologist

H
Hospitalist

I
Internist

L
Licensed mental health counselor

Licensed nurse (LPN or LVN)

N
Nurse practitioner (NP)

O
Obstetrician

Occupational medicine specialist

Occupational therapist

Ophthalmologist

Optician

Optometrist

P
Pathologist

Perinatologist

Pharmacist

Physical therapist

Physician assistant (PA)

Podiatrist

Psychiatric nurse

Psychiatrist

Psychologist

R
Radiologic technologist

Radiologist

Recreational therapist

Registered dietitian (RD)

Registered nurse (RN)

Respiratory therapist (RT)

S
Social worker

Speech therapist