Did your provider leave the network and you are in the middle of getting treatment?
In some situations, you may be able to continue going to your current provider at your plan’s in-network benefit level for up to 90 days after they leave the network, or until you no longer meet the criteria below, whichever is earlier. This is called continuity of care.
Examples of medical conditions appropriate for considerations for continuity of care include, but are not limited to:
- An individual undergoing a course of treatment for a serious and complex condition
- An individual undergoing inpatient or institutional care
- An individual with scheduled non-elective surgical care, including necessary post-operative care
- An individual who is pregnant and being treated
- An individual who is terminally ill and is receiving treatment for such illness by a provider or facility.