Does Medicare Require A Referral To See A Specialist?

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   Peggy Mace

   Most of the U.S.

   When using Medicare Advantage Plans, whether or not you have to get a referral to see a specialist depends on the plan in which you are enrolled. HMO's usually do require a referral; PPO's usually do not require one; PFFS plans do not require a referral, and SNP's usually do require one.
   
   Original Medicare does not require a referral to see a specialist. The specialist just needs to be Medicare qualified.

   Answered on September 10, 2013

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