Members

What Makes Vivity Unique

Unlike traditional HMO coverage options, Vivity offers you different ways to access care:

 Unique to Vivity, Expanded Choice* — Offers more access to doctors by letting members request care from certain specialists across Vivity’s network of medical groups. While typical health maintenance organizations (HMOs) only allow members to receive care from their medical group, the Expanded Choice feature gives them the choice of specialty care at partnering medical groups in the Vivity network if certain requirements are met: 

• Approval for the referral is at the discretion of the medical group based on whether the care is medically necessary.
• The specific specialty requested is offered with Expanded Choice.
• The specialists at the partnering medical groups can accept Vivity members.

* Members can request a referral from their primary care doctor for specialty care at a partnering Vivity medical group. The specialty care requested must be part of the specialties that are included in Expanded Choice, must be deemed medically necessary, and the specialists must be contracted to see Vivity patients from another partnering medical group.

Expanded Choice includes most specialty services. It excludes (i) ancillary services such as lab and radiology, and developmental and rehab therapies such as physical therapy, occupational therapy, and speech therapy; (ii) specialty services provided by a doctor of obstetrics and gynecology; and (iii) specialty services provided by a pediatrician.

 Unique to Vivity, the Nurse Patient Advocate collaborates with the Vivity Concierge and the Vivity health systems to ensure health plan members can access the care they need.

 Unique to Vivity, the away-from-home Guest Membership is available to members in California who are temporarily residing outside Vivity’s service area in Los Angeles and Orange counties. Members must contact the Vivity Concierge team for assistance in applying for in-state or out-of-state Guest Memberships.