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Talk with your primary care provider (PCP) before you make an appointment with another provider. You may need a referral from your PCP when you receive certain services outside your plan’s network. A PCP referral lets us know you can get care from a different provider.
Services that may require a referral include:
You should not be billed for any of these services if you get them from an in-network provider. In-network means you receive care within your plan’s network of providers.
You do not need referrals for outpatient behavioral health services, emergency care services, post-stabilization care services, OB/GYN services or family-planning services from any MassHealth-contracted, family-planning services provider.
Call our member services team at: