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For Members

Case Management Program

Our Case Management program provides a mix of benefit management and individual care planning to members diagnosed with a complex medical illness. Our skilled case manager will work with you and your health care team to develop short and long-term goals to help you maintain your quality of life-or, in some cases, make it better. Follow this link to learn about our Program for Children with Serious Illnesses.

To be eligible, you must:

  • Have complicated, multiple medical needs
  • Have a history of a medical condition that is difficult to control
  • Have an active health care policy administered by us
  • Agree to participate in our Case Management program

Services include:

  • Personalized care and coordination of services provided by a nurse case manager
  • Development of a care plan that addresses both your and your physician's health care goals
  • Assistance with benefit information to you and your health care team
  • Help obtaining referrals to community resources
  • Ability to be a liaison between you and your health care team

Case Management can:

  • Emphasize the importance of maintaining regular contact with your physician's office
  • Inform you about valuable community resources that can help with management of your illness
  • Offer tips on how to follow the treatment plan developed by your physician

Learn More:

For more information about this program, please contact us:

For information regarding Behavioral Health Case Management services in all regions:

  • Call 1-800-277-2198 (TDD/TTY 1-800-421-1220) Monday through Friday, 8 a.m. to 5 p.m.
    If you call after-hours, please leave a message and we will return your call by the next business day.