Referral

A written order from your primary care doctor for you to see a specialist or get certain medical services.

♦ In many Health Maintenance Organizations (HMOs), you need to get a referral before you can get medical care from anyone except your primary care doctor.

If you don’t get a referral first, the plan may not pay for the services.

• Primary care doctors are in effect gatekeepers for HMO plans.

Many people complain this is a way to ration care. The practice can save the plan money.

♦ Unfortunately, referrals tend to be to doctors and testing facilities financially tied to the organization the primary care doctor works for.