Completion of covered services by a terminated or non-participating provider may be provided under certain conditions. If you are new to Scripps Health Plan, or if your provider’s contract with Scripps Health Plan ends, you may request to continue treatment with your current provider for the following covered services:
- An acute condition
- A serious and complex medical condition
- A pregnancy
- A maternal mental health condition
- The care of a newborn child between birth and age 36 months
- Performance of a surgery or other procedure (including postoperative care)
- Inpatient or institutional treatment
- A terminal illness
New members who were offered an out-of-network option or who had the option to continue with their previous health plan or provider and instead voluntarily chose to change health plans, are not eligible for continuity of care with their provider.
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
- Continuity of Care form (PDF, 110 KB)for new enrollees
Learn more about the Continuity of Care Policy (PDF, 610 KB).