Specialist Care Jan 29, 2025

Seeing a Specialist 101

Need to see a specialist with your SCAN coverage? Learn when you can book directly (vision, dental, hearing) and when you’ll need a doctor’s referral. Get tips on referrals, approvals, and making appointments—all in one place!
Icon of a stethoscope.

When it’s time to see a specialist with your SCAN coverage, it’s important to know there are two types of specialty care:

  1. Self-referral. For services like dental, vision and hearing, you can make appointments directly without having to see your doctor.
  2. Doctor referral. For most specialty care, see your primary care doctor first to get connected to the right specialist.

1. Self-Referral Benefits

Vision

Is it time for your annual vision exam? Make an appointment with an EyeMed vision professional.
If you’re having a medical issue with your eyes, though, see your primary care doctor.

Find an EyeMed vision care provider:

Dental

Due for teeth cleaning or other dental care? If your SCAN plan includes a dental benefit, make an appointment directly with a Delta Dental dentist.

Find a dentist in your Delta Dental plan:

Hearing

Haven’t had your hearing checked yet? TruHearing will schedule an appointment for you with one of their hearing professionals.

Contact TruHearing:

2. Doctor Referral: See Your Primary Care Doctor First

In most cases, you will need to see your doctor for a referral to a medical specialist. Here’s what happens next:

  1. Your doctor submits a referral (or “prior authorization”) request to your medical group.
  2. You’ll receive a letter letting you know whether the referral has been approved.
    Tip: Find this sooner in your medical group’s patient portal.
  3. Your referral’s been approved? You’ll see the specialist’s contact information in the letter. That’s the go-ahead for you to call the specialist’s office and make an appointment.

Some medical groups don’t require a referral for certain routine preventive screenings or specialty care, like a mammogram or annual visit to a dermatologist. If you’re unsure about whether you need a referral for your care, find out from your doctor or medical group.

SCAN Club Issue 1 2025 Specialist Care
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