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Direct answer

It depends on the network type; HMO plans typically require a referral from a primary care physician to see a specialist, whereas PPO plans generally do not.

Standardized Centers for Medicare & Medicaid Services summary of benefits documentation. For additional information about how coverage works and to compare specific plan options, see the Centers for Medicare & Medicaid Services official website.


What this means for you

It depends on the network type; HMO plans typically require a referral from a primary care physician to see a specialist, whereas PPO plans generally do not.

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