Consumers often jump through hoops to get the medical care they need. Pain points include waiting on hold to make an appointment, scheduling an appointment that may be weeks or months away, and spending a lot of time in the waiting room and exam room. And let’s not forget about all the insurance processing and copays.
But the worst part is all these activities may only be the first step in getting your problem diagnosed and treated. This may be part of the referral process. You may need to see a doctor to get the okay to see a specialist who will address your problem.
So, is there any way to get the medical help you need without a referral? This article will explore the options.
Why Do I Need A Referral?
You need a referral mainly because your insurance company requires it. If you do not get a referral from your primary care doctor before seeing a specialist, your care may not be covered.
Insurance companies make referrals to prevent patients from seeing a specialist for a problem that a GP can solve. They realize that an unnecessary visit to a specialist would cost themselves and the patient extra time and money. However, many providers are doing away with referrals because the GP referral visits often cost more in the long run anyway.
It should also be considered that some patients may want to see their GP before seeing a specialist. If you trust your physician’s opinion, you may want them to be part of your continued care. You may also want their advice regarding which doctor you should see.
Can I Get Care Without A Referral?
While some people may want to talk to their doctor before seeing a specialist, many find it to be an unnecessary inconvenience. So, is there any way to see a specialist without a referral? Here are some options:
Get the Right Insurance Plan
Certain insurance plans, such as PPOs and EPOs, will not require you to get a referral. HMOs do require referrals.
PPOs (preferred provider organizations): PPOs give patients access to a network of providers in the area without referrals. You may also see a doctor outside the network, and the plan will cover your visit. However, they won’t provide as much coverage as they will for an ‘in-network’ visit.
EPOs (exclusive provider organization): EPOs can be described as a hybrid between a PPO and an HMO. You can see specialists without a referral, but visits to doctors outside the network won’t be covered. EPOs are typically not as expensive as PPOs.
HMOs (health maintenance organization): With an HMO, your primary care physician organizes all your health needs. You will need to see them before you are referred to any specialists. Some HMOs will let you see a doctor without a referral, so check to find out what your plan entails.
Go to the Hospital or Urgent Care
If you have a medical emergency, you may want to visit a hospital or urgent care. However, you may be looking at long wait times without an appointment. You will also need to see a facility within your network to get coverage.
Other Exceptions
Referrals aren’t typically needed for routine gynecological care such as Pap smears and mammograms. You may also not need a referral to see a mental health specialist.
Do I Need a Referral if I’m Not Insured?
No, you should not need a referral to see a specialist if you are not insured. However, without insurance, you will need to cover the total cost of your medical bill.
Is There Any Way I Can Save on My Medical Bill Without Insurance?
With no need for an insurance referral, some may ask, why bother with insurance? This is going through many people’s minds considering the high cost of copays and deductibles. But without insurance, you may be stuck with a high medical bill, especially if you are diagnosed with a serious condition.
So what’s the best solution? UBERDOC services may be the answer.
UBERDOC is an online platform that connects doctors with patients without having to go through insurance. Consumers can go online and schedule appointments with any one of our specialists without hold times. No referrals are needed.
As a bonus, patients can see doctors right away. Our doctors reserve exclusive appointments for our customers, so most patients get appointments in 1-3 days. And with most services costing just $250 a visit, we can save you money.
Medical referrals are a significant inconvenience. UBERDOC offers convenient medical services for less, and we will never require referrals. Look us up online to learn more about what we offer.
