October 25, 2017
Specialist Referral Requirement (Medicare)
Effective January 1, 2018, Health Partners Plans will require specialist referrals for most Health Partners Medicare members. To help prepare for this new requirement, review our list of Frequently Asked Questions, “FAQs,” related to this new requirement.
As always, a complete list of Health Partners Medicare participating specialists can be found on our Find a Docor page. For a printed list of participating specialists, contact our Member Relations department at 1-866-901-8000 (TTY 711).
This new requirement will include all Health Partners Medicare Special (HMO SNP) members as well as Health Partners Medicare Prime, Health Partners Medicare Value and Health Partners Medicare Basic members who reside in Philadelphia, Bucks, Chester, Delaware and Montgomery counties.
Specialist referrals will not be required for members enrolled in our Health Partners Medicare Prime and Health Partners Medicare Value plans who live in Lancaster, Lehigh and Northampton counties.
For questions or more information about the Medicare specialist referral requirement, contact our Provider Helpline at 1-888-991-9023 (9 a.m. to 5:30 p.m., Monday-Friday).