The Alliance is committed to ensuring that our eligible members receive medically necessary services without interruption.

We have a continuity of care process for providers not contracted with the Alliance (also known as out-of-network). New Alliance members may continue to see their non-contracted physicians and utilize specific medical services, for up to 12 months for their medical services after enrollment, as long as the following Continuity of Care guidelines are met. If your providers do not join the Alliance network by the end of 12 months, you will need to switch to providers in the Alliance network.

If your provider stops working with the Alliance, you may be able to keep getting services from that provider. This is another form of continuity of care.

Alliance Group Care Members

The Alliance provides continuity of care services for:

  • Acute Condition – Completion of covered services shall be provided for the duration of the acute condition.
  • Diagnosed Maternal Mental Health Condition – A mental health condition that impacts a woman during pregnancy, peri- or postpartum, or that arises during pregnancy, in the peri- or postpartum period, up to 12 months after delivery.
  • Pregnancy (including care after the birth) – Completion of covered services shall be provided for the duration of the pregnancy when (1) the pregnancy is high-risk, or (2) the member is in her second or third trimester.
  • Serious Chronic Condition – Completion of covered services shall be provided for the period of time necessary to complete a course of treatment and to arrange for a safe transfer to another provider, as determined by the Alliance in consultation with the member and the non-participating provider, and consistent with good professional practice. Completion of covered services shall not exceed 12 months from the time you enroll with the Alliance.
  • Surgeries and/or Procedures – Performance of surgeries and/or other procedures that the member’s previous plan authorized as part of a documented course of treatment, and that had been recommended and documented by the non-participating provider to occur within 180 days of the time the member enrolled with the Alliance.
  • Terminal Illness – Completion of covered services shall be provided for the duration of the terminal illness. Completion of covered services may exceed 12 months from the time you enroll with the Alliance.

To learn more or request continuity of care, please call:

To learn more about your benefits and covered services, please view your Alliance Group Care Member Handbook.