• You choose a primary care physician who coordinates all your care.
  • You need a referral from your primary care physician to see other doctors in the plan network. For more information, see How do referrals work in my HMO plan?
  • In an emergency, go to the nearest doctor or hospital. Eligible services are covered in Michigan, the U.S. and abroad.
  • If you go to a doctor or hospital without a referral or outside the plan network when it isn't an emergency, you'll pay the entire cost. Always ask your primary care physician for help coordinating your care.

Who qualifies as a primary care physician?

  • Family and general practice doctors who treat patients of all ages and provide obstetric and gynecologic care.
  • Preventive medicine doctors who promote health and well-being for patients of all ages.
  • Internal medicine doctors who identify and treat illnesses in adolescent, adult and geriatric patients. Most patients are 18 and older.
  • Internal medicine and pediatric doctors who identify and treat illnesses in infants, children, adolescents and adults.
  • Pediatricians who treat infants, children and adolescents under age 18.

If you don't get a referral from your primary care physician to see a specialist in another area, such as a dermatologist, you'll have to pay for the entire cost of the service.