What is a single case agreement?

A: A single case agreement (SCA) is a one-off contract between your health plan and an out-of-network therapist, letting you see that therapist at in-network cost. Plans grant them when their network can't meet your need: no timely appointment (the 10-day rule →), no clinician with a required specialty or language, or continuity of care after your therapist leaves the network.

Worked example: your longtime therapist drops your plan. You request a continuity-of-care SCA; the plan approves 12 months at your old $30 copay instead of her $190 fee.

Do this: call member services and say: "I'm requesting a single case agreement because the network cannot provide [timely access / this specialty / continuity of care]. What's the process?" Put it in writing after the call; appeal denials via the DMHC (1-888-466-2219).

Source: H&S §1367.03 (timely access); H&S §1373.96 (continuity of care) — leginfo.legislature.ca.gov.