Your PCP or another specialist will provide you a referral to visit a specialist within the time frame listed in the Timely Access to Care section of this handbook, if you need one. A specialist is a doctor who has extra education in one area of medicine. Your PCP will work with you to choose a specialist. Your PCP’s office can help you set up a time to go to the specialist.
Other services that might need a referral include in-office procedures, X-rays, lab work and specialists.
Your PCP may give you a form to take to the specialist. The specialist will fill out the form and send it back to your PCP. The specialist will treat you for as long as they think you need treatment.
If you have a health problem that needs special medical care for a long time, you may need a standing referral. This means you can go to the same specialist more than once without getting a referral each time.
If you have trouble getting a standing referral or want a copy of the L.A. Care referral policy, call Member Services at 1-888-839-9909 (TTY: 711).
You do not need a referral for:
- PCP visits
- Obstetrics/Gynecology (OB/GYN) visits
- Urgent or emergency care visits
- Adult sensitive services, such as sexual assault care
- Family planning services (to learn more, call the Office of Family Planning Information and Referral Service at 1-800-942-1054)
- HIV testing and counseling (12 years or older)
- Sexually transmitted infection services (12 years or older)
- Chiropractic services (a referral may be required when provided by out-of-network FQHCs, RHCs and IHCs)
- Initial mental health assessment
- Ongoing mental health therapy
Minors can also get certain outpatient mental health services, sensitive services and substance use disorder services without parent’s consent.
Visit the Minor consent services and Substance use disorder treatment services pages to learn more about these services.