Last Updated: September 20, 2026
Can I Keep My Doctor After Joining a Medi-Cal Health Plan? Continuity of Care 2026 Guide
I was receiving care through Fee-for-Service Medi-Cal, but now I have to join a Medi-Cal Managed Care Plan. My current doctor is not in the new plan's network. Do I have to change doctors immediately?
Not necessarily. Depending on your situation, you may be able to request Continuity of Care (CoC) and temporarily continue seeing your existing Medi-Cal provider.
If you were required to move from FFS Medi-Cal into a Managed Care Plan and you have an existing relationship with a Medi-Cal provider who is not in your new plan's network, you may be able to keep that provider for up to 12 months.
This protection is called Continuity of Care.
What Is Continuity of Care?
Continuity of Care may allow qualifying Medi-Cal members to temporarily continue receiving care from an existing Medi-Cal provider who is outside their new Managed Care Plan's network.
Continuity of Care does not return you to Fee-for-Service Medi-Cal. You remain enrolled in your Medi-Cal Managed Care Plan while temporarily continuing care with an eligible out-of-network provider.
Who May Qualify?
- You were required to enroll in a Medi-Cal Managed Care Plan.
- You want to keep a Medi-Cal provider who is not in your new plan's network.
- You saw that provider at least once during the previous 12 months.
- The provider is willing to work with your new plan and make an agreement with the plan to get paid.
Example: Ongoing Cancer Treatment
Maria has been receiving cancer treatment from the same oncologist through FFS Medi-Cal.
She is required to enroll in a Medi-Cal Managed Care Plan and discovers that her oncologist is not in the new plan's network.
Maria may ask her new Medi-Cal Health Plan for Continuity of Care.
If she meets the requirements and her oncologist agrees to work with the plan, she may be able to continue treatment with the oncologist while remaining enrolled in her Medi-Cal Health Plan.
How Do I Request Continuity of Care?
Contact your current Medi-Cal Health Plan.
Call the Member Services number on your plan card and tell the representative that you want to request Continuity of Care with your existing provider.
“I recently enrolled in this Medi-Cal health plan, but my current doctor is not in the plan's network. I have been receiving care from this doctor and would like to request Continuity of Care so I can continue my treatment.”
What Information Should I Have Ready?
- Your Medi-Cal Health Plan and Member ID
- Your provider's name
- Provider contact information
- Your medical condition
- The treatment you are receiving
- When you last saw the provider
- Any upcoming appointments or treatments
How Long Can Continuity of Care Last?
Qualifying members may be able to continue seeing an existing provider for up to 12 months.
This does not mean every request automatically receives exactly 12 months. The applicable rules and individual circumstances matter.
MER vs. Continuity of Care
| Medical Exemption Request (MER) | Continuity of Care (CoC) |
|---|---|
| Requests temporary exemption from mandatory Managed Care enrollment | You remain enrolled in Managed Care |
| If approved, you temporarily remain in FFS Medi-Cal | You may temporarily continue with an eligible out-of-network provider |
| Requested through Medi-Cal Health Care Options | Requested through your current Medi-Cal Health Plan |
If you are currently receiving treatment for a complex medical condition from an FFS provider and changing providers could cause your condition to worsen, a Medical Exemption Request may be relevant to your situation.
Can I Leave My Medi-Cal Health Plan and Return to FFS? Medical Exemption Request (MER) 2026 Guide
What If My MER Was Denied?
A denied MER does not necessarily mean that you must immediately stop seeing your existing provider.
DHCS states that when an MER is clinically denied, the Medi-Cal Managed Care Plan is required to consider the request as a Continuity of Care request to complete a course of treatment with an existing FFS provider.
If your MER was denied, contact your new Medi-Cal Health Plan and ask whether you qualify for Continuity of Care.
What If I Have Medicare and Medi-Cal?
These CoC rules concern your Medi-Cal providers.
If you have both Medicare and Medi-Cal, your Medi-Cal Health Plan does not limit which Medicare providers you may see for Medicare-covered services.
Key Takeaways
Request CoC from your current Medi-Cal Health Plan.
CoC does not return you to FFS Medi-Cal.
If you need a temporary exemption from mandatory Managed Care enrollment, MER is a separate process.
If an MER is denied, ask your plan whether you qualify for Continuity of Care.
Official Resources
Disclaimer:
This website provides general information about California public benefit programs and is for informational purposes only. It is not affiliated with or endorsed by any government agency and does not provide legal, medical, or professional advice. Program rules, eligibility requirements, benefits, and procedures may change. For the most current information and guidance about your individual situation, please contact the appropriate government agency, county office, health plan, or program administrator.