Do I need a referral to see a specialist?
HAP does not require you to get a referral to see a specialist in your network for an initial consultation. However, the specialist you visit may require a referral from your primary care physician. The schedules for certain specialists get filled months in advance. They may only accept patients whose primary care doctor believes the patient needs specialty care.
Here's an example: Mary suffers from chronic sinus infections several times a year, so she wants to see an ear, nose and throat doctor. She schedules an appointment with the specialist within her network. HAP doesn’t require a referral for Mary to see this doctor. The doctor’s office may require a referral from Mary’s primary care physician. This is not a HAP requirement. HAP doesn’t have any involvement in the doctor’s request.