Approvals and Referrals

Prior approval and referrals depend on your plan. To learn more, log in to Blue Connect and read member's frequently asked questions (FAQs).

Prior approval and referrals depend on your plan. To learn more, log in to Blue Connect and read member's frequently asked questions (FAQs).

If you do not receive prior approval or certification for services (except emergency care or maternity), your claim may be denied, paid at a lower benefit, or a penalty may be applied.

You do not need to get a referral from your primary care provider to receive covered services from a participating specialist. However, some participating specialists may require a new patient introduction from your treating doctor.

Services for mental health and substance abuse must be approved in advance by Magellan Behavioral Health.