What happens if my doctor leaves your network?
Who is this for?
If you're a Blues member, use this information to figure out if you can still get treatment from a doctor who is leaving your insurance plan’s network.
We know the relationship with your doctor is important to your health and well-being. And we do everything within our control to assure you have a great, long-term relationship with your doctor.
While it doesn’t happen often, occasionally a doctor will leave our network. You might be able to continue to see that doctor under several special circumstances.
For instance, if you’re seeing a specialist and receiving an ongoing course of treatment, we don’t want to disrupt that care and interfere with your recovery. You may continue care:
- For up to 90 days after your doctor notifies you they are leaving the network.
- Through postpartum care, if you are in the second or third trimester of pregnancy when your doctor leaves the network.
- For the rest of your life if you are being treated for terminal illness before the doctor leaves the network.
Continuing care with your doctor isn’t automatic. Your doctor has to agree to continue treating you and needs to notify you of that in writing.
Your doctor should also agree to accept our reimbursement as payment in full and follow our policies and procedures for referrals and pre-authorizations while they are treating you.