What does Medicare Advantage typically require for specialist visits?

Medicare Advantage plans commonly require a referral from a primary care physician for specialist visits. This requirement is in place to promote coordinated care and ensure that patients receive appropriate treatment within the context of their overall health management. By obtaining a referral, the primary care physician can help guide patients to the right specialist and provide relevant medical information to facilitate effective care. This approach not only helps in managing costs but also enhances the continuity of care, as the primary physician typically oversees the patient's health journey.

It's important to note that some Medicare Advantage plans may have different rules, and certain plans could allow direct access to specialists without a referral. However, as a general rule, the referral practice is a common feature of many Medicare Advantage plans.