You'll need a referral to see specialists
With this plan, you need a written or electronic referral from your primary care doctor before receiving specialist care. A referral is permission from your primary doctor to see a specialist. Specialists are doctors such as allergists or dermatologists who provide services other than primary care. Your primary care doctor will take care of the referral for you.
Some specialists do not need referrals. You do not need a referral for the following specialist services:
- Chiropractic care.
- Outpatient mental health services, like therapists.
- OB-GYN care.
- Diabetes-related eye exams from an ophthalmologist.
You'll need prior approval for some services
In some circumstances, you have to get approval before you receive certain services. This is known as prior approval. Examples of these services include: inpatient nonemergency procedures, outpatient surgery, home health care, hospice care, and outpatient physical, occupational, and speech therapies.
You'll need to use Quest Diagnostics for lab work
Be sure to remind your doctor to use Quest Diagnostics when lab testing is needed. For details about these services, you can call our Gold Line. You can also go to questdiagnostics.com, or call Quest Diagnostics directly at 888-277-8772 to schedule an appointment.
Health care assistance
We know this is a lot of information, and we want to make sure that you understand and know the basics about your plan. Your Gold Line agent is available to walk you through your plan details and benefits. Call 833‑CNY‑GOLD (833-269-4653) (TTY: 711) Monday to Friday, 8 a.m. to 8 p.m., and Saturday, 8 a.m. to 1 p.m. Have your new Gold member ID card ready when you call.