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Self-referrals to AmeriHealth Caritas network providers

Self-referrals are services you can arrange for yourself without first calling your PCP. You must see an AmeriHealth Caritas network provider for these self-referred services. Services that do NOT need a referral or prior authorization are:

  • Prenatal visits
  • Routine obstetric (OB) care
  • Routine gynecological (GYN) care
  • Routine mammograms, with a prescription
  • Routine family planning services**
  • Routine dental services, if you are eligible for dental services under the Medical Assistance program*
  • Routine eye exams*
  • Prescription eyeglasses for members under 21 years of age
  • Tobacco cessation counseling sessions**
  • First visit with a chiropractor
  • First 24 visits for outpatient physical, occupational and speech therapy
  • Emergency services**
  • DME purchases costing less than $500 that are covered by the Medical Assistance program and with a prescription (find out more about prior authorization).

* You may need to get a referral or prior authorization from your PCP for some specialty care services. There may also be some limitations for self-referrals. If you are not sure if you need a referral from your PCP for a service, ask your PCP or call Member Services.

** This self-referred service may be provided by a provider not in the AmeriHealth Caritas network.