Effective January 1, 2009 referrals are no longer required for all Health Maintenance Organization (HMO) and Point-of-Service (POS) plan members.
Members will still need to select a primary care physician (PCP) to coordinate their care and guide their decisions, but are not required to obtain a referral prior to seeing a participating specialist.
Requirements for prior authorization are not affected by this change.
New Optima ID cards for affected members will display the words “No Referral Required” to make it clear that their plan is now referral-less.
If you have any questions, please contact your Network Educator.