Obtaining a referral does not guarantee payment. All plan limitations and exclusions still apply. Charges for treatment received beyond the length of the referral period will be reimbursed at the non-network level. At the time of the visit, you will pay a copayment and any applicable coinsurance amount. For network benefits, physician assistants and advanced nurse practitioners must be employed by and supervised by a network PCP or specialist.
Maternity care is also available for eligible dependent children.
To receive these services at the network level of coverage, simply schedule an appointment with a network optometrist or ophthalmologist and obtain care. It is no longer necessary to first visit your PCP or obtain a referral. If your network provider discovers a condition requiring additional treatment, you must have a referral from your PCP in order to receive network benefits. To receive non-network benefits, schedule an appointment with any appropriate valid provider and receive care. Your PCP is not utilized in this process .