Advantage Referral banner

Advantage Referral

father and daughter

Membership with Western Health Advantage means choices and flexibility for specialty care. WHA’s unique Advantage Referral program allows your doctor to refer you to many of the specialists in our network, not just within your particular medical group.


Our partnership with our medical groups expands your choices of specialty physicians. With Advantage Referral you have access to many of the specialists in our network not just from your particular medical group. You can ask your primary care physician (PCP) to refer you to any of the specialists in the Advantage Referral program.

OB/GYN services for women and annual eye exams (when covered) are included in the Advantage Referral program. These services do not require a PCP referral or prior authorization, as long as the specialist is in the Advantage Referral program.


While your PCP will treat most of your health care needs, if your PCP determines that you require specialty care, your PCP will refer you to an appropriate provider. You may request to be referred to any of the WHA network specialists in the Advantage Referral program. You can search WHA’s online Provider Directory or call Member Services.


When medically appropriate, your doctor will send a written referral to your medical group’s Utilization Management department. A referral takes five days to complete for routine requests and 72 hours for an expedited request. Once the referral is processed you will receive notification with details of your referral.

Note: If you receive care from a WHA network specialist prior to receiving a referral, you may be liable for the cost of those services.


No, Advantage Referrals do not require prior authorizations (pre-approval) since your PCP has established medical necessity by requesting the services of a specialist.

Note: Specialists who do not participate in the Advantage Referral program are designated in our Provider Directory. UC Davis Medical Group does not participate in the Advantage Referral Program. UC Davis-affiliated enrollees are not eligible to participate in the Program.

We are currently enhancing the online renewal system. Please check back soon. For immediate assistance, contact a WHA Individual Plan Specialist at 888.563.2250 or

This SBC is currently unavailable online.
For assistance, please contact WHA Sales as described below.

Call 888.563.2250 or email

Este documento en español está siendo actualizado y no está disponible en línea. Por favor de, llamar a Servicio al Cliente 888.563.2250 para solicitar que se le envíe por correo.

The site you are transferring to is not hosted by WHA. WHA's Terms of Use and internet Privacy Practices do not apply to your use of this linked site. Please review the policies on privacy and terms of use for the linked site. WHA does not control the accuracy, completeness, or timeliness of the content on the linked site.

Press Esc to cancel

El sitio Web al que está siendo transferido no es provisto por WHA. Las Condiciones de Uso y las Prácticas de Privacidad en Internet de WHA no se aplican a este sitio Web asociado que usted está usando. Revise las políticas sobre la privacidad y condiciones de uso de este sitio Web asociado. WHA no tiene control sobre la exactitud, la totalidad o la actualidad del contenido del sitio Web asociado. WHA no puede garantizar que los servicios de traducción de idiomas estarán disponibles en el sitio vinculado.

Presione «Esc» para cancelar