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Continuity of Care (COC)

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.

Continuity of Care Assistance Request Form

Are you currently receiving medical treatment?

If you or a covered family member are enrolling in an HMO plan and are currently receiving ongoing medical treatment or treatment from a non-participating provider, call Member Services for CalPERS at 1-888-926-4921 as soon as possible. A representative will help you determine if you're eligible for continuity of care assistance.

Are you currently receiving behavioral health care?

If you (or a covered family member) are currently receiving mental health services or substance use disorder treatment (inpatient or outpatient), please call Managed Health Network, LLC (MHN) as soon as possible at 1-888-926-5108. If your current provider is not an MHN network provider, we will connect you with a care manager who will carefully review your situation and arrange for medically appropriate continuity of your care to an MHN participating provider.