If you get ongoing treatment from a provider who is not in the First Choice Next network, you may be able to keep getting that treatment.
Treatment or services are "ongoing" if you were treated during the past 12 months for a condition that needs follow-up care or additional treatment. Services are also ongoing if they were already approved.
Continued care eligibility
You are allowed to continue ongoing treatment with a health care provider who is not in our network when either of the following happens:
- You are a new First Choice Next member and you are getting ongoing treatment from a health care provider who is not in the First Choice Next network.
- You are a current First Choice Next member and you are getting ongoing treatment from a health care provider whose contract has ended with First Choice Next for reasons that are "not for cause."
Reasons that are "not for cause" means the provider's contract did not end because of the quality of the provider’s care or because the provider did not meet other contract or regulatory requirements.
If you have questions, call Member Services at 1-833-983-7272, Monday through Friday, 8 a.m. to 8 p.m. ET.