Human Resources

Q:

Do I need a referral or preauthorization before having surgery or seeing a specialist?



A:

Under the State Health Plan, subscribers do not need a referral before seeing a specialist; however, some services do require preauthorization by Medi-Call, including inpatient surgery. For services that require preauthorization, check the list in the Insurance Benefits Guide or contact Medi-Call. Your physician may call to preauthorize services for you, but it is your responsibility to ensure the call is made. Medi-Call can be reached by calling 800-925-9724. 

BlueChoice subscribers only receive benefits for coveredservices when using a network provider. Your primary care physician must refer you to a specialist or surgeon before services are covered.




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