Continuity of Care (COC)
When you switch health plans, you may be eligible to continue your care with your current doctors or medical groups.
This is called Continuity of Care.
You have 60 days after you are enrolled in this plan to request Continuity of Care.
Here is a list of conditions eligible for Continuity of Care:
- an acute condition;
- a serious chronic condition – up to twelve months;
- a pregnancy (including the duration of the pregnancy and immediate postpartum care);
- maternal mental health – up to 12 months from the diagnosis or from the end of the pregnancy;
- a newborn up to 36 months of age - up to 12 months;
- a terminal illness; or
- a surgery or other procedure that has been authorized and scheduled by your prior health plan as part of a documented course of treatment within 180 days of new plan effective date.
Medical
Are you currently getting medical treatment?
If you or a family member gets medical treatment from an out-of-network provider for one of the medical conditions above, fill out the form below or call Member Services at 1-888-926-1692 as soon as you can. A representative will help you decide if you can receive continuity of care support.
- Continuity of Care Assistance Request Form – English (PDF)
- Continuity of Care Assistance Request Form – En Español (Spanish) (PDF)
Pharmacy
If you are taking any of the drugs listed on the Prescription Transition form (below), fill it out, and return it to Health Net.
- Prescription Transition form – English (PDF)
- Prescription Transition form – En Español (Spanish) (PDF)
If you work for an employer who is in the pharmacy business, your network may be more restrictive than what shows on this site.
Behavioral Health
If you (or a covered family member) are getting mental health services or substance use disorder treatment, call the Mental Health Benefits number listed on the back of your Health Net ID card as soon as possible. If your current provider is not in our provider network, you may be eligible for Continuity of Care. You will be connected with a care manager who will review your status and will either arrange for a medically appropriate transfer of your care to a Health Net participating provider, or will facilitate a Continuity of Care request.