2026 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 (except for C-SNP members).

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

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

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