Dealing with Hard-to-manage Health Conditions?

Our care managers can help

Our medical, behavioral health (mental health and/or substance use) and social care managers work closely with you and each other to coordinate the care you need. We provide three types of integrated care management services:

Complex care medical management

  • Extra services to help you manage your ongoing conditions, like intensive-care newborn needs, severe disability, cancer, HIV/AIDS and/or organ transplant
  • Support with acute illnesses/catastrophic health events, such as motor vehicle accidents, stroke, etc.

You can call 888.257.1985 to get complex care medical management services, or your in-network physician can refer you to the program. Based on claims data, a Tufts Health Plan care manager may contact you to discuss your needs and interest in the program.

Behavioral health (BH) intensive clinical management 

  • A greater level of support and services for your BH care
  • Available if you have acute or severe, persistent BH issues, need help accessing community-based services, are newly diagnosed with a major mental illness, or have had three or more BH inpatient hospital admissions over a period of 12 months 

Social care management

  • Help accessing non-medical services/resources for food, clothing, disability support, housing and other needs that affect your health and well-being

We can help you make and keep appointments, find out what resources and benefits you can get, and coordinate your care with your providers. We also can help you learn about alternatives and resources for continuing care, and how to obtain them when your benefits are exhausted.

Call us at 888.257.1985 (TTY: 711), Monday through Friday, from 8 a.m. to 5 p.m., to talk to a care manager.