Have some Health Insurance “network” plans allow you to see a specialist with a referral?

Have some Health Insurance “network” plans allow you to see a specialist with a referral?

Questions by Fjsuidfj Jiodfjsk ūüėē Have some Health Insurance “network” plans, you can see a specialist with a referral
I am a United Healthcare One, and it is a “network” level, and it says is: Practicing physician (PCP) P√•kr√¶vetIngenHenvist to a specialist P√•kr√¶vetIngenOut-of-Netv√¶rksd√¶kningJaHar some Health Insurance “network” plans allow you to see a specialist without reference? SORRY typo Best answer:

Reply mbrcatz
Yes, and this seems to be one of them.


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4 Replies to “Have some Health Insurance “network” plans allow you to see a specialist with a referral?”

  1. After looking at your other questions you don’t have a clue what you are doing. You need to contact a local agent that can explain all of the plans to you and can take the time to make sure you know what you’re getting. There is no charge using an agent; the cost of the plans are the same, and you would spend much less time using an agent than you already have trying to do “do it yourself” insurance.

  2. It’s not an HMO so you don’t need a referral. Why are you not asking your insurance broker about this? You should be buying this plan (assuming it’s the best one for you) through a broker. It costs no extra, but they can help you with simple questions like this, help you find a company, a plan, help you apply, and then help you with any claim and billing issues. UHC is one of my favorites – I have it personally. They pay their claims quickly AND they answer the phone when you have questions…which is nice since I am my broker so I have to call them with questions.

    And, Zarnev is spot on….when help is free, quit trying to circumvent it. Uneducated consumers buy insurance direct or through large online sites. Educated consumers realize there is no additional cost to get professional help.

    Also, FYI “network” for all intents and purposes IS just like a PPO — and they used to call it a PPO.

  3. You are looking at what is defined as a Preferred Provider Organization plan, PPO for short. PPO’s base their premiums on negotiated fee schedules with physicians and hospitals that agree to be in the insurer’s network. So the quality of a PPO health plan is going to be based on the size and scope of the network.

    So yes you can “self-refer” yourself to a specialist. But if you refer yourself to physician or hospital outside of the network you will pay a significant penalty through a higher deductible and higher coinsurance participation. Some additional coverage such as well baby care, immunizations, physicals or preventative health will not be covered at all if you go out of network.

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