Continuity of Care

Continuity of Care for an out-of-network provider

As a member of L.A. Care, you will get your health care from providers in L.A. Care's network.

To find out whether the health care provider is in the L.A. Care network please see the L.A. Care online Provider Directory. Providers not listed in the directory may not be in the L.A. Care network.

In some cases, you might be able to get care from providers who are not in the L.A. Care network. If you were required to change your health plan or to switch from FFS to managed care, or you had a provider who was in network but is now outside the network, you might be able to keep your provider even if they are not in the L.A. Care network. This is called continuity of care.

If you need to get care from a provider who is outside the network, call L.A. Care to ask for continuity of care.
You may be able to get continuity of care for up to 12 months or more if all of these are true:

  • You have an ongoing relationship with the out-of-network provider before enrollment in L.A. Care
  • You went to the out-of-network provider for a non-emergency visit at least once during the 12 months before your enrollment with L.A. Care
  • The out-of-network provider is willing to work with L.A. Care and agrees to L.A. Care’s contract requirements and payment for services
  • The out-of-network provider meets L.A. Care’s professional standards
  • The out-of-network provider is enrolled and participating in the Medi-Cal program

To learn more, call Member Services 1-888-839-9909 (TTY 711).

If your providers do not join the L.A. Care network by the end of 12 months, do not agree to L.A. Care payment rates or do not meet quality of care requirements, you will need to change to providers in the L.A. Care network. to discuss your choices, call Member Services 1-888-839-9909 (TTY 711).