Transition of Care

Transition of Care

Transition of care benefits may be available to your employees and their dependents as a member of a new plan joining during open enrollment.

Transition of care allows patients with certain medical conditions to continue their treatment with non-participating providers, at the network level of benefits, for a specified period of time

Applying for Transition of Care

Examples of acute medical conditions that may qualify for transition of care benefit include, but are not limited to:

Examples of conditions that generally do not qualify for transition of care benefits include, but are not limited to:

Frequently Asked Questions:

  • What timeframe is allowed for transitioning to a participating provider?

    Upon approval of your request, you will be notified in writing of the number of days for which your transition of care benefits are approved, which is 90 days or less

  • If I am approved for transition of care benefits for one illness, can I receive in-network benefits for a non-related condition?

    In-network benefit levels provided in conjunction with transition of care are for the specific illness/condition only and cannot be applied to another illness/condition.

  • Can I apply for transition of care benefits if I am not currently in treatment or seeing a physician?

    Individuals must currently be receiving treatment for the condition by the physician that is noted on the transition of care form.

  • Do I need to complete the Transition of Care Request Form if I am already seeing a participating provider?

    No, you do not need to request transition of care if your provider is already participating in Sutter or Anthem Blue Cross' network. To verify a provider's status, Sutter physicians and facilities contact BRMS directly by calling the number on your member identification card.