Continuity of Care

What If My Doctors Are Not in my Cal MediConnect Plan?

You can keep your doctors for a period of time.
Tell your doctor or your Cal MediConnect plan you want to make a “continuity of care” request.

 

If your doctor is NOT part of your Cal MediConnect health plan, you have a right called “continuity of care.” You can continue to get care from your doctor for 12 months for Medi-Cal or Medicare services.

  • If you want to keep seeing your doctors, make sure you had at least 1 visit with him or her in the last 12 months.
  • Your doctor must be willing to work with the Cal MediConnect plan and accept payment from the plan.
  • Your doctor must not be kept out of the plan’s network for quality or other concerns.

How do I ask for continuity of care?

Before you choose a Cal MediConnect health plan, call the plan or (1-800-434-0222) to see if your doctors are in the plan’s network.

If one of your doctors is NOT in the network:

  1. Call your Cal MediConnect health plan and tell them about the care you have scheduled with your doctor.
  2. Tell your plan that you want to keep seeing your doctor. The doctor must agree to work with the plan network.

You can also ask your doctor. Your doctor or authorized representative can make the continuity of care request to the plan.

Continuity of care is temporary.

If your doctor does not join Cal MediConnect, you will need to change to a doctor in the Cal MediConnect network. You will have to do this by the end of the 12-month period. Your health plan and Care Coordinator can help you with this change.

If your doctor does not join Cal MediConnect, you will need to change doctors. But you have the right to keep getting the services you need.