How and When to Switch Your Health Plan Provider

We get it. Sometimes you need to switch your Primary Care Physician (PCP).

Maybe you’re moving and your current doctor’s office is too far away. Maybe your doctor is retiring or moving to a new practice. Or maybe it’s just taking too long to get an appointment, and you’d like to try someone new.

Whatever your reason, the good news is that changing doctors is typically a simple process.

Changing Doctors in an HMO

If you’re in an HMO (Health Maintenance Organization), you can usually make the change online through your health plan account.

1. Log in to your account and search for a new doctor in your health plan’s provider directory.
2. Confirm the doctor is part of your plan’s network and that they’re accepting new patients.
3. Request the change — online or by phone — to make your new doctor your PCP.

Once your request is processed, you’ll receive confirmation (by mail or email). It’s also a good idea to contact your current doctor’s office to have your medical records transferred to your new provider.

Your change usually takes effect on the first day of the month after your request. For example, if you submit your change on May 19, you’ll likely be able to see your new doctor in June.

Changing Doctors in a PPO

If you’re in a PPO (Preferred Provider Organization), the process is similar but a bit more flexible.

1. Use your plan’s online directory to find a new in-network doctor.
2. Call the office to confirm they’re taking new patients and that they’re in your plan’s network.
3. Ask your health plan to update your records with your new doctor.

If your new doctor is in the same medical group as your current one, you might be able to make the switch directly through that group.

Again, be sure to request that your medical records be sent to your new provider, and schedule an introductory appointment to review your care and any ongoing treatments.

You’re in Control

It’s your health. You should always feel comfortable with your doctor and care team. When searching for a new provider, most online directories let you filter by:

• Name
• Medical specialty
• City or ZIP Code
• Distance from home or work
• Physician gender
• Language(s) spoken
• Health plan
• Hospital affiliation
• Medical group

As a CaliforniaChoice member, you can use the online Provider Director on calchoice.com. Or, visit your health plan’s website to explore more options.

If you have questions, the CaliforniaChoice Customer Service Center is here to help. Call 800-558-8003 or email CustomerService@CalChoice.com.