Do I need a referral?
Wednesday, April 16, 2025
None of Health Trust medical plans require that members obtain a referral from a primary care physician (PCP) in order to receive in-network specialty care. This insurance referral requirement was eliminated for members who participate in the Acadia and Baxter (formerly POS C and POS 200) plans effective January 1, 2025, to lessen burdens to receiving necessary care.
You no longer need to designate a PCP, and the Health Trust will not collect or maintain PCP data in our systems. It is not necessary that you let us know if your provider changes, and your PCP is no longer listed on your ID card.
However, some specialists may still require that you be seen by another provider before receiving specialty care. This is referred to as a medical referral, and these requirements are set by the providers.
While it is not needed for your insurance, we strongly encourage members to maintain a relationship with a primary care provider, which could be a doctor, nurse practitioner, physician assistant or other clinical provider. This will facilitate medical referrals and scheduling of appointments with specialists. Furthermore, having a relationship with a primary care provider has been shown to lead to better long-term health outcomes.
If you have questions or would like assistance in finding a primary care provider, please contact Health Trust Member Services at 1-800-852-8300 or via email at [email protected].