Do you have to have a referral to come for medical help?

Yes, from your primary physician

Referrals from your primary care physician are usually only necessary for appointments with specialists. There are many general practitioners in Family or Internal Medicine that you can make appointments with without a referral (might depend heavily on your insurance company).

You do not need a referral to make an appointment with a primary care provider. Some insurance companies require referrals before paying for the services of specialty providers. Please check with your insurance company to see if the specific service requires a referral. https://muschealth.org/patients-visitors/insurance https://muschealth.org/medical-services/primary-care

You probably need one from your primary care physician unless you go through their emergency department.