Blue Shield of California Promise Health Plan (“Blue Shield Promise”) Continuity of Care program helps eligible Medi-Cal plan members stay under the care of a current provider who have changed plans from fee-for-service (FFS) Medi-Cal plan into a Medi-Cal managed care plan (MCP).

The Continuity of Care program allows members to complete their care with their current healthcare provider in specific cases.

Continuity of Care forms
San Diego English (99 KB)
Spanish (558 KB)
Chinese (261 KB)
Farsi/Persian (258 KB)
Arabic (214 KB)
Tagalog (661 KB)
Vietnamese (223 KB)
Los Angeles English (99 KB)
Spanish (558 KB)
Arabic (214 KB)
Armenian (210 KB)
Chinese (261 KB)
Farsi-Persian (258 KB)
Khmer/Cambodian (200 KB)
Korean (203 KB)
Russian (226 KB)
Tagalog (661 KB)
Vietnamese (223 KB)

Please call customer service if you require assistance filling out the Continuity of Care form:

 Los Angeles County: (800) 605-2556 (TTY: 711), 8 a.m. - 6 p.m., Monday – Friday.

 San Diego County: (855) 699-5557 (TTY: 711), 8 a.m. - 6 p.m., Monday – Friday.

Please return this completed form to:

Blue Shield of California Promise Health Plan
P.O. Box 629005
El Dorado Hills, CA 95762

Medi-Cal benefits

Find the health benefits you get as a Blue Shield of California Promise Health Plan Medi-Cal member.