UNDERSTAND YOUR BENEFITS
Coverage and Benefits
Your benefits provide coverage for the care you need, help maintain your good health and better manage your health care costs.
Transitioning Your Care
When you enroll 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 Jan. 1, 2027
- 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
Ask a Health Advocate. Contact a Health Advocate if you believe you or a covered dependent is eligible for transitional care. Call 1-855-552-7960 (8 a.m. – 6 p.m. CST).
Download the Transition of Care Form