Continuity of Care (COC)

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

• Continuity of Care Assistance Request Form – English (PDF)
• Continuity of Care Assistance Request Form – En Español (Spanish) (PDF)

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 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.