Can I See an Ophthalmologist Without a Referral?

When your eyes are bothering you, you don’t want to jump through hoops—you just want answers, fast. One of the most common questions we hear at Trinidad Vision Cataract and Laser Eye Center is: “Can I see an ophthalmologist without a referral?” The answer: it depends on your insurance plan—but don’t worry, we’ll walk you through it.

Which Insurance Plans Require a Referral?

Certain health insurance plans, especially Health Maintenance Organizations (HMOs) and Medicare Advantage Plans, often require a referral from your primary care provider (PCP) before you can see a specialist, including an ophthalmologist.

Insurance Type Referral Required? Notes
HMO Usually Yes Must go through your PCP to see a specialist.
Medicare Advantage (some plans) Often Yes Many Advantage plans are structured like HMOs.
PPO (Preferred Provider Organization) Usually No You can usually see specialists without a referral.
Traditional Medicare No You can see an ophthalmologist directly.
TriCare Prime Yes Referral through military primary care provider.
TriCare Select No Direct access usually allowed.

If your plan requires it, a referral must come from your primary care physician (PCP). This is typically submitted electronically through your insurance portal or faxed directly to our office.

We know that navigating this process can be frustrating. That’s why at Trinidad Vision, we’ve built a concierge-style practice model that works for you—not against you.

We’ll Call for You

Our experienced staff is trained to handle the referral process. If we see that your insurance plan requires a referral, we don’t just hand you a slip and send you on your way—we:

  • Contact your PCP directly to request the referral.
  • Coordinate with your insurance to ensure it's properly documented.
  • Confirm with you once everything is approved so your visit isn’t delayed.

You focus on your health—we’ll handle the red tape.

When You Don’t Need a Referral

Even if your plan technically requires a referral, there are exceptions. For example, if you have a sudden eye emergency, like acute vision loss or trauma, most plans will allow you to see a specialist immediately without a referral. If you're unsure, just give us a call and we'll help assess the urgency and your plan's requirements.

Dr. Trinidad’s Concierge Experience

When you book with me, Dr. Jake Trinidad, you’re not just getting a board-certified ophthalmologist—you’re entering a patient-first practice where we remove barriers to care. My team is happy to check your benefits ahead of time, and we’ll do whatever is necessary to ensure a smooth experience.

You shouldn’t have to fight your insurance company to protect your vision. At Trinidad Vision, we do the work so you can focus on healing.

Need an appointment or have questions about your insurance? Contact us today online or over the phone to get started.