Our complex care management program is for members who have long-lasting medical and behavioral health (mental health and/or substance use) conditions.
Your complex care management team understands the problems that people with special health care needs have. We work with you to arrange for care, services and equipment; teach you about your condition(s); and design the best plan of care for your needs. We coordinate with your care team (doctors, nurses, nurse practitioners and care managers) to make sure you get the right care, in the right place, at the right time. We are able to visit you in your home or community or talk with you on the phone to ensure your needs are being met.
You may benefit from our complex care medical management if you are dealing with things, such as:
- Multiple health conditions that are hard to manage
- Intensive-care newborn needs
- Pediatric care needs
- Cancer
- HIV/AIDS
- Organ transplant(s)
- Severe disability or impairment
- Severe traumatic injury
- High-risk pregnancy
- Frequent hospital admissions or emergency room visits
Getting services
We may reach out to you based on medical and pharmacy claims data to see if you would like complex care management support. In addition, you can:
- Call us at 888-257-1985 (TTY: 711) and request complex care management support.
- Ask your physician(s) to call 888-257-1985 and refer you to the program. A nurse care manager will then contact you to discuss your needs and interest in the program.
For more information, call us at 888-257-1985 (TTY: 711), Monday through Friday, from 8 a.m. to 5 p.m. We’re happy to help.