If you need a specialist for your care, your PCP or another specialist will give you a referral to one.
A specialist is a provider who focuses on one type of health care service. The provider who refers you will work with you to choose a specialist.
To help make sure you can go to a specialist in a timely way, DHCS sets time frames for members to get appointments. These time frames are listed in the Timely Access to Care section of this handbook. Your PCP’s office can help you set up an appointment with a specialist.
Other services that might need a referral include in-office procedures, X-rays, and lab work.
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 might need a standing referral. Having a standing referral 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)
- 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.
To learn more, visit the Minor consent services and Substance use disorder treatment services sections of this online handbook.