Continuity of Care Information
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What is Continuity of Care?
Continuity of care for new members means that you may be able to continue seeing your current doctor or therapist for up to 12 months after you have been enrolled in a Medi-Cal managed care health plan. A Medi-Cal managed care health plan will be referred to as the “Plan.”
Generally, you may be able to receive Continuity of Care if you were seeing a Regular Medi-Cal doctor or therapist and were required to enroll in a Plan in the last year. In addition:
You must have seen your doctor or therapist at least once during the last 12 months, and
Your doctor must be willing to work with your new Plan.
Continuity of Care also means that you can continue receiving the medical services and medicines you need after you have been enrolled in a Plan. If you have received a prescription or authorization for a medicine, service, treatment, procedure, or surgery scheduled to occur after you join a new Plan, you will still be able to receive it. In some cases, you may need to have a different provider deliver the care or perform the procedure you need. Talk to your new Plan doctor about what services and medicines you need.
Be sure to read the Frequently Asked Questions for more detailed information about this or contact your Plan.
How Can I Request to Keep Seeing My Doctor?
Call your Medi-Cal Managed Care health plan to find out if you qualify to continue seeing your provider. Tell your health plan that you want to continue seeing your current doctor. You will need to provide the name of your doctor or hospital, your medical condition, and the treatments you are receiving. If your doctor agrees to keep seeing you as a patient and will work with your new Medi-Cal managed care plan, you may be able to continue seeing your doctor for up to 12 months.
Be sure to read the Frequently Asked Questions for more detailed information about this or contact your Medi-Cal managed care health plan.