Continuity of Care

Continuity of Care

A new member may request to receive the continuation of covered services being provided by a non-participating provider, if at the time of the member’s enrollment with SFHP, the member was receiving services from that provider for one of these conditions:

  • An acute condition
  • An acute exacerbation of a chronic disease
  • Pregnancy for all three trimesters, including the immediate postpartum period
  • A terminal illness, under compassionate care, on a case-by-case basis
  • Care of a newborn child in the first 30 days, under mother’s enrollment
  • An authorized covered service to be provided within 180 days of the effective date of the member’s effective date of enrollment with SFHP

SFHP shall only provide for the continuation of services that would otherwise be Covered Services under the terms of the member’s benefit program.

Contact SFHP’s Customer Service at 1(415) 547-7800 or 1(800) 288-5555 to request continuity of care from a terminated provider, or a non-contracted provider.