Can I Keep My Doctors and Other Providers?
If you join a Cal MediConnect health plan, your providers (including your primary provider) must be in that plan. This is called the plan’s network.
Find out if your doctors are part of Cal MediConnect.
If you have doctors that you know and trust, find out if they are in a Cal MediConnect health plan. To find out, you can:
- Call the Cal MediConnect health plans in your county to ask if your doctors are in their networks.
- Visit the Cal MediConnect health plans’ websites to view provider and pharmacy directories.
- Ask your doctors if they are in a Cal MediConnect plan.
- Call HICAP at 1-800-434-0222. They can help you find out if your doctors are in a Cal MediConnect plan. HICAP is the Health Insurance Counseling & Advocacy Program.
If your doctors ARE part of Cal MediConnect:
- Make sure you join the Cal MediConnect health plan that includes your doctors.
If your doctors are NOT part of Cal MediConnect, you can:
- Work with your Care Coordinator to choose doctors in your plan’s network.
- You may be able to keep seeing your current doctors for a while after you join Cal MediConnect. This is called “continuity of care.”
- Ask your doctor if he or she would consider joining a Cal MediConnect health plan.
What are the different types of providers?
- Primary Care Provider: A health care provider that gives you basic care and refers you to other providers for follow-up care; including with specialists. He or she can be a family doctor, nurse practitioner, or physician’s assistant.
- Specialist: This is a doctor who focuses on a specific area of medicine. Examples are
cardiologists, oncologists, psychologists, and others.
How can I choose a primary care provider in my Cal MediConnect health plan?
As a Cal MediConnect member, you must have a primary care provider. Your health plan can
help you choose one that meets your needs.
- You can choose one for yourself or the plan will choose one for you.
- If you do not like your primary care provider you can work with your health plan to find
- Your primary care provider may belong to a medical or provider group. Your primary care
provider will refer you to specialists in the same provider group to treat specific conditions.
How do I change my provider?
You should always have providers who you trust and who meet your needs.
- If you are not happy with your care, let your provider’s office know your concerns.
- If you do not want to try another appointment with that provider, you may ask to see another in the same medical group. Or work with your health plan to find a new provider or new medical group.