Caring for your health, or the health of someone you love, becomes more important, and sometimes more complex, as the years go by. Aging often brings new medical needs, new questions, and occasionally new fears. It can feel overwhelming when you are suddenly being sent to specialists with unfamiliar titles, or when you do not fully understand what they do. Learning the purpose and role of different healthcare specialists can help you understand how each provider can help support your overall health and bring clarity and peace of mind to each of us and the people we love.
Each of these specialists is intended to work together to support the whole person, mind, body, and spirit, and this knowledge can help you advocate for yourself, someone you care for, or have a better overall understanding.
Insurance considerations
Insurance coverage can be one of the most confusing parts of healthcare, especially when it comes to specialty visits. While not always required based on the type of insurance you have, a referral from a primary care provider can often help things happen faster and prevent complications with insurance. If you ever have a concern about potential costs or a denial of service, it is always best to contact your insurance company. Understanding how your coverage works and knowing which services may require referrals, prior authorization, or specialist involvement can help prevent delays in care, unexpected costs, and unnecessary stress. For example, some insurance plans classify geriatricians as specialists rather than primary care providers.
Diagnostic Testing
Most diagnostic tests require prior authorization to confirm medical necessity before they are scheduled. Cardiology tests such as stress tests, ECGs, cardiac monitoring, and advanced imaging, as well as imaging ordered by neurology, orthopedics, or vascular specialists, often need insurance approval. Bone density scans and specialized endocrine testing may also require referrals, prior authorization, or use of in-network facilities. It is helpful to contact your insurance company before scheduling, as the provider who orders the test is usually responsible for submitting the authorization. In some cases, insurers require stepwise testing, such as approving an X-ray before allowing an MRI, which can affect the timing of care.
Therapies and Rehabilitation Services
Typically, they have limits on the number of visits and require referral. Physical therapy and occupational therapy usually need a referral, often capped at a set number of visits per year, and may be limited to specific diagnoses or time-limited goals. After orthopedic surgery, physical therapy is generally covered but may include a limited number of approved sessions.
Laboratory testing, infusions, and specialized studies
Tests, infusions, and specialized studies often require additional insurance coverage. Kidney-related laboratory tests and dialysis services may be covered only when ordered directly by a nephrologist. In contrast, hematology and rheumatology care frequently involves specialized labs, infusions, and biologic medications that require prior authorization or documentation showing that other treatments were tried first. Pulmonary rehabilitation, sleep studies, and CPAP therapy often require pre-authorization, with coverage tied to documented symptoms, diagnostic findings, and trials of conservative treatment. Cancer care adds another layer of complexity, as it often involves repeated lab tests, imaging, medications, and procedures coordinated among multiple specialists. Nearly all major cancer treatments require pre-authorization, and coverage decisions may depend on cancer type, stage, and prior therapies. Most cancer centers offer financial counseling services to help patients and caregivers navigate these complex coverage requirements.
Helpful tip for patients and caregivers
Before scheduling specialist visits, tests, or procedures, ask three key questions:
Is a referral required?
Is prior authorization needed?
Are there limits on visits, tests, or therapy sessions?
Taking these steps ahead of time can turn insurance from a source of frustration into a manageable part of the care journey, allowing patients and caregivers to focus on what truly matters: health, comfort, and quality of life.
Geriatric Medicine
Geriatricians are primary care physicians who specialize in adults aged 65 and older. Geriatric medicine focuses on the “whole-person approach,” recognizing that older adults often experience multiple chronic conditions that interact with one another.
Geriatricians evaluate:
• Memory and cognitive health
• Fall risk and mobility
• Medication safety (polypharmacy)- Polypharmacy means taking many medications at the same time, usually five or more. It is very common in older adults because they often have several health conditions, see different doctors, and need ongoing treatment to stay well.
• Chronic illness management
• Functional ability in daily tasks
They coordinate care among multiple specialists and ensure treatments do not conflict. For example, a geriatrician may simplify medications to prevent side effects or confusion, adjust treatments to preserve independence, or recommend home safety evaluations.
Why you might see them: Memory changes, balance problems, medication confusion, or multiple health issues that require coordinated care.
Cardiology
Cardiologists diagnose and treat heart and blood vessel disorders. Heart disease remains the leading cause of death among older adults, making cardiology a central specialty for aging patients.
Cardiology has numerous subspecialties:
Interventional Cardiology
Performs minimally invasive procedures such as stent placement and angioplasty to open blocked arteries.
Electrophysiology
Treats heart rhythm problems, including atrial fibrillation, requiring pacemakers, defibrillators, or ablations.
Heart Failure Specialists
Guide complex treatment plans for chronic heart failure and coordinate medications, lifestyle changes, and monitoring.
Preventive Cardiologists
Focus on reducing risk factors such as high blood pressure, diabetes, obesity, and cholesterol through personalized prevention plans.
Why you might see them: Chest pain, shortness of breath, fatigue, swelling in the legs, abnormal heart tests, palpitations, or a history of heart disease.
Neurology
Neurologists diagnose and treat conditions affecting the brain, spinal cord, and nerves. Neurological disorders, including dementia, Parkinson’s disease, stroke, peripheral neuropathy, and movement disorders, are significant causes of disability in older adults.
Neurology subspecialties include:
Cognitive Neurology
Focuses on dementia, Alzheimer’s disease, mild cognitive impairment, and memory disorders.
Movement Disorder Specialists
Treat Parkinson’s disease, tremors, gait abnormalities, and conditions affecting movement and coordination.
Neuromuscular Neurologists
Evaluate peripheral neuropathy, nerve pain, muscle weakness, myasthenia gravis, and other nerve-muscle disorders.
Stroke Neurologists
Assess stroke risk, manage recovery, and coordinate rehabilitation and prevention strategies.
Why you might see them: Memory loss, numbness, tingling, tremors, balance problems, new confusion, or unexplained weakness.
Endocrinology
Endocrinologists treat hormone-related conditions. Aging bodies often experience changes in endocrine function, especially in relation to diabetes, thyroid disease, and osteoporosis.
Endocrinology subspecialties include:
Diabetes Management
Focuses on blood sugar control, medication adjustments, and the prevention of complications such as neuropathy and kidney disease.
Thyroid Disease
Diagnoses hypothyroidism, hyperthyroidism, thyroid nodules, and autoimmune thyroid conditions.
Bone and Mineral Metabolism
Manages osteoporosis, vitamin D deficiency, and calcium regulation.
Pituitary and Adrenal Disorders
Evaluates hormonal imbalances affecting energy, blood pressure, and metabolism.
Why you might see them: Weight changes, fatigue, brittle bones, uncontrolled diabetes, or abnormal blood tests.
Nephrology
Nephrologists specialize in kidney health. Older adults, especially those with diabetes or high blood pressure, are at higher risk of chronic kidney disease (CKD). Early intervention slows progression toward kidney failure.
Nephrologists manage:
• Chronic kidney disease stages 1–5
• Electrolyte imbalances
• Dialysis planning and monitoring
• Kidney complications from medications
• Fluid retention and swelling
Why you might see them: High creatinine levels, swelling in legs, long-term diabetes or hypertension, or protein in urine.
Pulmonology
Pulmonologists diagnose and treat lung and respiratory diseases, including:
• Chronic obstructive pulmonary disease (COPD)
• Asthma
• Pulmonary fibrosis
• Chronic bronchitis
• Sleep apnea
COPD is one of the leading chronic conditions affecting older adults. Pulmonologists may perform lung function tests, oxygen evaluations, bronchoscopy procedures, or manage sleep studies.
Pulmonology subspecialties include:
Pulmonary Rehabilitation Specialists
Support breathing exercises, endurance training, and strategies to reduce shortness of breath.
Sleep Medicine Specialists
Diagnose sleep apnea and manage CPAP therapy and sleep-related breathing disorders.
Critical Care Pulmonologists
Care for patients with severe respiratory failure, pneumonia complications, and ICU needs.
Why you might see them: Chronic cough, difficulty breathing, fatigue, snoring, or sleep disturbances.
Rheumatology
Rheumatologists treat autoimmune diseases, inflammatory disorders, and chronic joint conditions. Arthritis affects nearly half of adults over age 65, making rheumatology essential.
Common conditions include:
• Osteoarthritis
• Rheumatoid arthritis
• Lupus
• Gout
• Polymyalgia rheumatica
• Fibromyalgia
Rheumatology subspecialties include:
Inflammatory Arthritis Specialists
Manage immune-related joint destruction and prescribe disease-modifying medications.
Autoimmune Disease Specialists
Treat system-wide autoimmune disorders affecting joints, organs, and connective tissue.
Bone and Joint Health Specialists
Focus on mobility preservation and pain reduction.
Why you might see them: Joint swelling, morning stiffness, chronic pain, or unexplained inflammation.
Oncology
Oncologists treat cancer, but oncology includes multiple subspecialties because cancer is not a single disease; it is a category with many different types requiring specialized care.
Major oncology subspecialties include:
Medical Oncologists
Coordinate chemotherapy, targeted therapies, immunotherapy, and hormonal therapy.
Radiation Oncologists
Provide radiation treatments for cancerous tumors using advanced imaging guidance.
Surgical Oncologists
Perform tumor-removal surgeries, biopsies, and complex cancer procedures.
Hematologic Oncologists
Treat blood cancers such as leukemia, lymphoma, and multiple myeloma.
Gynecologic Oncologists
Manage cancers of the uterus, ovaries, cervix, and reproductive organs.
Gastrointestinal Oncologists
Specializes in colon, stomach, pancreatic, and liver cancers.
Breast Oncologists
Focus on breast cancer diagnosis, imaging, and targeted treatment.
Stem Cell Transplant Teams
Care for patients requiring marrow or stem cell transplants for certain blood cancers. These treatments are often performed at specialized centers and require long-term follow-up.
Why you might see them: Abnormal imaging, suspicious biopsy results, unexplained weight loss, or newly diagnosed cancer.
Hematology
Hematologists treat blood disorders, including:
• Anemia
• Platelet disorders
• Clotting disorders (DVT or pulmonary embolism risk)
• Leukemia, lymphoma, or myeloma
• Bone marrow abnormalities
Subspecialties include:
Coagulation Specialists
Manage bleeding or clotting disorders such as hemophilia or thrombosis.
Transfusion Medicine Specialists
Oversee blood transfusions and evaluate chronic anemia.
Hematologic Oncologists
Overlap with oncology to diagnose and treat blood cancers.
Why you might see them: Persistent fatigue, unexplained bruising, frequent infections, or abnormal blood tests.
Ophthalmology
Ophthalmologists diagnose and treat eye diseases, perform surgery, and manage vision complications in older adults. Four common age-related eye conditions:
• Cataracts
• Glaucoma
• Macular degeneration
• Diabetic retinopathy
Ophthalmology subspecialties include:
Retina Specialists
Treat diabetic eye disease, macular degeneration, and retinal tears.
Glaucoma Specialists
Manage eye pressure and prevent optic nerve damage.
Cornea Specialists
Treat corneal disease, dry eye, and perform corneal transplants.
Oculoplastic Surgeons
Perform eyelid, tear duct, and facial reconstructive surgeries.
Audiology
Audiologists diagnose hearing and balance disorders. Hearing loss is strongly connected to cognitive decline, fall risk, and social isolation.
Audiology subspecialties include:
Hearing Aid Specialists
Evaluate and fit devices to improve communication and safety.
Vestibular Specialists
Diagnose dizziness, vertigo, and balance problems.
Cochlear Implant Teams
Evaluate severe hearing loss that may require surgical implants.
Physical Therapy
Physical therapists (PTs) help restore mobility, strength, balance, and endurance. PT reduces fall risk and improves independence.
Therapists assist with:
• Post-surgery rehabilitation
• Strength training
• Balance improvement
• Pain relief
• Chronic disease management
Occupational Therapy
Occupational therapists (OTs) help older adults stay independent in daily activities such as dressing, bathing, cooking, and managing medications.
OTs specialize in:
• Home safety evaluations
• Memory support strategies
• Adaptive equipment
• Energy conservation techniques
• Functional rehabilitation
Podiatry
Podiatrists treat foot and ankle conditions. Healthy feet are essential for balance, mobility, and preventing falls. Foot care is particularly important for older adults with diabetes, neuropathy, or circulation problems. Their focus is generally below the knee.
They treat:
• Wounds
• Bunions
• Nerve pain
• Swelling
• Diabetic foot ulcers
• Ingrown toenails
Vascular Medicine and Surgery
Vascular specialists diagnose and treat blood vessel diseases affecting circulation. These diseases can lead to ulcers, clots, aneurysms, or strokes if untreated.
Vascular subspecialties include:
Peripheral Artery Disease (PAD) Specialists
Treat poor circulation in the legs that causes pain while walking.
Venous Specialists
Manage vein disease, varicose veins, and blood clots.
Aneurysm and Aortic Specialists
Monitor enlarged arteries and prevent rupture.
Orthopedics
Orthopedic doctors diagnose and treat musculoskeletal issues involving bones, joints, muscles, tendons, and ligaments.
Orthopedics has many subspecialties:
Joint Replacement Specialists
Perform hip, knee, or shoulder replacements and manage severe arthritis.
Sports Medicine Orthopedists
Treat tendon tears, ligament injuries, and cartilage damage.
Spine Orthopedists
Manage spinal stenosis, disc problems, and back pain.
Hand and Upper Extremity Specialists
Treat carpal tunnel, arthritis of the hand/wrist, and shoulder injuries.
Foot and Ankle Orthopedists
Focus on fractures, deformities, or chronic ankle instability.
Trauma Orthopedists
Treat fractures from falls, which are common in older adults.
Final Thought
Aging does not mean losing independence, but sometimes it may require a team of professionals to support your well-being. While each specialist brings a unique skill set and treatment approach, together they form a team that supports the maintenance and improvement of your mobility, cognition, heart health, emotional well-being, and everyday functioning.
We know that healthcare can feel overwhelming, but you are not alone. Improving knowledge and preparation can make navigating the healthcare system feel a little easier.