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Referral Services

What is a Referral?

A referral is when your PCP sends you to another doctor or facility in our plan to get care. Most often, it will be a specialist. The specialist has extra training in a certain area of medicine.

Services That Require a Referral

You may see any doctor in our network without a referral. However, some doctors may request a referral from your PCP. We will still cover medically necessary services provided by an in-network provider without a referral. You may be referred to another provider if:

  • Your PCP does not provide the care or service you need
  • You need to see a specialist

You could be referred for medical tests, treatments or other services. Referrals for certain care or services do not require our approval. These include:

  • Routine diagnostic tests
  • Lab tests
  • Basic X-ray services
  • Some routine care provided in a doctor’s office (not in a hospital)
  • Mental health or substance abuse services

WellCare of Nebraska Plan Documents

A preferred drug list is a list of drugs covered by your plan.

Supplemental Drug List information

NE Family Planning Drug List Information

Fill out and submit this form for prior authorization (PA) for your Medicaid prescriptions.

Downloadable copy of the Lock-In Provider Choice Form.


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Last Updated On: 3/2/2018