This content is for general informational purposes and does not constitute medical, legal, or financial advice. Healthcare rules and costs change annually. Last reviewed: January 1, 2025. Always verify current details with your insurer, employer, or a licensed healthcare navigator.
Specialist
A doctor with advanced training in a specific area of medicine, such as cardiology or dermatology.
Full Definition
A specialist is a physician who has completed additional training beyond general medicine in a specific field — such as cardiology (heart), oncology (cancer), orthopedics (bones/joints), or dermatology (skin). Specialists typically see patients referred by primary care physicians. Specialist visits often have higher copays or coinsurance than primary care visits. Some plans require a referral from your PCP to see a specialist; others (PPOs, EPOs) allow direct specialist access.
Real-World Example
After your PCP finds an irregular heart rhythm, they refer you to a cardiologist (specialist). Your plan charges a $60 specialist copay — double the $30 PCP copay — for the cardiology visit.
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