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Seeing a Specialist

AmeriHealth Caritas Iowa covers your visits to specialists in our network.

What is a specialist?

Your PCP can treat most health problems. However, there may be times when you need to see a specialist. A specialist is a doctor trained to treat certain health problems.

Specialists can include:

  • Heart doctors (cardiologists).
  • Skin doctors (dermatologists).
  • Doctors for women’s issues (gynecologists).
  • Doctors for pregnant women (obstetricians).
  • Doctors for blood problems (hematologists).
  • Foot doctors (podiatrists).
  • Eye doctors (ophthalmologists).
  • Cancer doctors (oncologists).
  • Surgeons.
  • Psychiatrists.

How to get care from a specialist

You can find specialists in our network by using Find a doctor. You do not need a referral to see a specialist in our network.

A specialist may think you need surgery or other treatment. You can ask to see another specialist. This is called a “second opinion.” If you want a second opinion, ask your PCP to help you find another specialist in our network. There is no limit to how many times you may see the specialist.

Out-of-network providers

You need prior approval to see providers who are not in our network. Your doctor will help you get approval.

Sometimes, we may not have a provider who can treat your health problem. You can ask to see a provider who is not in our network. Talk to your PCP about out-of-network providers.

If you have questions about out-of-network providers, call Member Services at 1-855-332-2440 (TTY: 1-844-214-2471) 24 hours a day, 7 days a week.