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What is a gatekeeper?

Dr. Michael Roizen, MD
Internal Medicine

When I think of a gatekeeper, those giant lion-sphinx-like creatures hovering outside the gates of ancient Egyptian temples come to mind. While those particular gatekeepers did control who came into those sacred places, the term has come to mean something fairly different in the insurance world.

For those with traditional HMOs, your primary care physician (PCP) is your gatekeeper. This doc oversees and coordinates all of your medical care. The gatekeeper must approve medical tests and treatments and even refer you to specialists for additional medical care.

Sometimes, point-of-service (POS) plans have gatekeepers, but YOU usually decide whether to have one or not.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.