We provide continuity of care for our members, including:
- Those being treated for acute conditions, serious chronic conditions, pregnancies (including immediate postpartum care) and terminal illness
- Children from birth to 36 months of age
- Those who have received authorization from a now-terminated or non-participating provider for surgery or another procedure as part of a documented course of treatment
Members may request completion of care in certain situations with a provider who is leaving the Scripps Health Plan provider network.
Transitions of Care (TOC) is for new enrollees who are undergoing an active course of treatment from a nonparticipating provider. However, you are not eligible for this transition of care provision if, at the time you selected this plan, you had the option to continue with your previous plan and voluntarily chose to change health plans. (PDF, 240 KB)
Contact customer service at 844-337-3700 or TTY: 888-515-4065 for the hearing and speech impaired, to request the following:
- Information regarding eligibility criteria
- The policy and procedure for requesting continuity of care from a terminated or non-participating provider
- Transition of Care form (PDF, 240 KB)for new enrollees
Learn more about the Continuity of Care Policy (PDF, 180 KB).