Transitioning Your Care
Our providers offer a wide range of advanced treatments across all specialties, and our Member Care Services are available to help you find the care you need. However, we understand there are times when you are in the middle of care and need special assistance to be sure the transition of your care does not result in any lapses in care. We can help you find the specialist you need. In some cases, it may be necessary to approve limited continuing care with your current out-of-network providers to achieve a safe transfer of care.
ELIGIBILITY TO TRANSITION YOUR CARE
- Members who are new to the plan and whose providers are not in the network
- Existing members whose provider has left our network
ELIGIBLE MEDICAL CONDITIONS MAY INCLUDE:
- Pregnant or delivered in the last six weeks
- Hospitalized at the time of the new plan year
- Scheduled to have surgery in the new plan year
- In chemotherapy or radiation therapy for cancer
- Diagnosed with a terminal illness
- Getting treatment for complex acute or chronic conditions
TIMING
You can request a short-term extension once you enroll. Once your membership is active, you have up to 90 days to make a request. If you have any questions, call Member Care Services at 1-855-345-7422, Monday – Friday, 6:30 a.m. – 7:00 p.m. PT.
REQUEST TRANSITION OF CARE
Ask for a short-term extension to use an outside provider with our Transition of Care Request Form. If this is regarding receiving a mental health treatment, please fill out the Transition of Care for Mental Health Request Form.
Download Transition of Care Request Form
NEED HELP OR HAVE QUESTIONS?
Call Member Care Services:
1-855-345-7422
Monday – Friday,
6:30 a.m. – 7:00 p.m.