Transition of Care

If you enrolled in a new health plan, your provider network may change. If you are currently receiving treatment from a doctor who is not part of your new network, you may apply to continue treatment with that doctor temporarily. Review the following transitional care criteria for eligibility.

Examples of medical conditions that may meet the guidelines:

• Pregnancy in the third trimester
• Patients who are hospitalized prior to January 1st of the current year
• Terminal illness where life expectancy is less than six months
• Long-term treatment of cancer, heart disease, transplants

Examples of medical conditions that do not meet the guidelines:

• Routine care (immunizations, physicals)
• Chronic conditions that are stabilized (asthma, diabetes, heart disease)
• Minor illness or injury (flu, sore throat, sprains)
• Elective surgery

Contact Customer Service at 1-877-325-2996 if you (or a covered dependent) believe you are eligible for transitional care.

Request for Transitional Care Benefits and Release of Information