Covered California Requires You Have A Doctor Or You Will Be Assigned A Doctor


Covered California Requires You Have A Doctor
On August 17th Covered California began sending letters to all enrollees that have PPO plans. The letter states that your insurance company is going to assign you to a Physician on January 1st, 2017. This is described in the letter as a “new feature.” Should you be worried?

Thank you for enrolling in health coverage through Covered California. We have news about a new feature that will be available with the PPO (Preferred Provider Organization) plan you are currently enrolled in, beginning January 1, 2017. What is it?

Beginning January 1, 2017, your health insurance plan will select a Primary Care Physician for you. Once your Primary Care Physician is selected, you will be able to change to another physician at any time you choose.

“Covered California Requires You Have A Doctor” Letter to an SPF Insurance client.

We’ve received many calls about this letter. The bottom line is that you don’t have to do anything to keep your existing doctor. The insurance companies are required to make sure you are seeing a doctor by the end of 2016. If you have not seen a doctor since you enrolled in your plan, the insurance company will assign a Primary Care Physician (PCP) to you.

This only effects you if you have a PPO or EPO plan. If you have an HMO plan then you already have a PCP, so there will be no change.

If the insurance company assigns a doctor, you can change this doctor by calling your insurance company.

If you have not used a doctor since starting your plan, you can search for your own doctor and then notify your insurance company about the doctor you want to have assigned as your PCP.

Use our Doctor Search Tools to help you select your PCP.

Covered California is requiring all health insurance companies in California to implement this “new feature” during the upcoming Open Enrollment Period.

What Do You Need To Do?

You don’t need to do anything if you want to keep your existing doctor.

If you have any questions, contact us and our advisers will be able to help you.


Here is the explanation we brokers received “Primary Care Physician Matching Quick Guide” from Covered California.


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