Care Management Is All About You

Keeping yourself healthy is important. We are here to help you learn more about your health. Our care management programs give you a chance to:

• Ask questions about your health.
• Get information about your benefits.
• Connect with local resources.

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Get your digital ID card, see your claim status, view plan details and check your benefits.

How Care Management Works

Our care management team is made up of: 

  • Nurses.

  • Diabetes educators.

  • Health coaches.

  • Therapists.

  • Other health experts. 

They will help you manage your health and improve your quality of life.

 

When you join our program, your care manager will:

  • Help you make a plan to reach your health goals.

  • Coach and support you on your health journey.

  • Help you track your progress.

  • Give you information about local resources.

  • Answer questions about your condition and the ways to treat it.

  • Send you materials so you can learn about your health and wellness.

  • Coordinate your care with your health care providers. He or she will help you:

    • Make appointments.

    • Get to doctor visits.

    • Get referred to specialists in our health plan if you need them.

    • Get medical equipment you may need.

 

View Care Management Rights and Responsibilities

Who Can Participate in Care Management?

Any Healthy Blue member can take part in our programs. We are here for you whether you are healthy and comfortable managing your health on your own or need a little help. We offer community events to help you learn how to take charge of your health. We also offer personal health coaching and case management for those who need more support.

How To Join

If we identify you for care management, you will get an invitation to enroll by mail, email or text. If you are not automatically identified for care management and you would like to join one of our programs, you can also call us at 866-781-5094 (TTY 866-773-9634) from 8 a.m. to 6 p.m. Monday through Friday. 

 

When you join, we will:

  • Create a care plan that fits your life. 

  • Set up health care services. 

  • Help with referrals and requests for service. 

  • Send health records to your doctors when they need them. 

You can ask us to take you out of the program at any time. Please call us at 866-781-5094 (TTY 866-773-9634) from 8 a.m. to 6 p.m. Monday through Friday if you want us to take you out of the program. You may also call this number 24 hours a day to leave a private message for your care manager.

Our Programs

Chronic Kidney Disease (CKD)

Our chronic kidney disease (CKD) program helps members with stages 1 – 3 kidney disease.  Members can learn how to manage their condition and reduce the risk of developing complications through this program. 

The program consists of:

  • Educational materials.

  • Individualized telephonic care management.

  • Important health reminders. 

All Healthy Blue members with CKD can participate in the program. We will enroll members with CKD automatically with no charge. 

 

Learn more about CKD:

Chronic Obstructive Pulmonary Disease (COPD)

Our COPD program is our educational program for members with chronic obstructive pulmonary disease (COPD). COPD is a chronic disease of the lungs. It really consists of two diseases: 

  • Chronic bronchitis.

  • Emphysema.

The number one cause of COPD is cigarette smoking. You can also get it from other things. COPD can be a serious illness. You can help manage it with proper medicine and simple lifestyle changes.

All Healthy Blue members with COPD can participate in the program. We will enroll members automatically with no charge. 

 

Learn more about COPD:

Depression

If you suffer from depression, you are not alone. Depression is one of the most common conditions. It affects more than 19 million Americans each year. You cannot just “snap out” of depression. Depression needs treated like any other serious illness. We offer care management for depression to help members manage their condition. With the program, you will work with a clinically trained behavioral care manager. Your care manager can help you better understand your depression and the best ways to manage it. 

All Healthy Blue members can participate in the program. We automatically sign-up members with depression at no charge.

 

Learn more about depression:

Diabetes

Our diabetes program helps you learn how to manage your diabetes better. We educate you about how to:

  • Reduce your risk of complications.

  • Improve your quality of life.

All Healthy Blue members can join the diabetes program. We automatically sign-up members with diabetes at no charge. 

 

Learn more about diabetes:

Heart Disease

Our heart disease program helps you learn how to better manage your heart disease. We automatically enroll all members with heart disease at no charge. Our goal is to:

  • Help you understand more about your condition.

  • Show you steps you can take toward good health.

 

Learn more about heart disease:

Heart Failure

Our Heart Failure program helps you learn how to better manage your congestive heart failure (HF). We automatically enroll all Healthy Blue members with HF at no charge. Our goal is to help you learn to manage your symptoms so you can keep doing the things you enjoy. 

We automatically enroll members with heart failure at no charge.

 

Learn more about heart failure:

High Blood Pressure

Our High Blood Pressure program is an educational program for members who want to learn more about managing high blood pressure and making lifestyle changes to manage important cardiovascular risk factors. 

We automatically enroll members with high blood pressure at no charge. Ready to get started? Read the info below to help you learn about managing your blood pressure.

 

Learn More About High Blood Pressure: 

High Cholesterol

High Cholesterol is an educational program for members who want to learn more about: 

  • How to lower their cholesterol levels.

  • Make lifestyle changes to manage important cardiovascular risk factors. 

We automatically enroll members with high cholesterol at no charge. 

 

Learn more about high cholesterol:

Maternity Program

Congratulations! Pregnancy is an exciting time with a lot of changes and emotions. It can also be overwhelming. You may have questions. Our maternity program provides you with information and support throughout your pregnancy and postpartum period.

Learn More About Our Maternity Program 

Metabolic Health

Our metabolic health program is made to help those who struggle with obesity or prediabetes. Our care managers will work with you to develop a plan to reach your health goals. This includes helpful information on: 

  • Eating healthy.

  • Exercising.

  • Losing weight. 

We will automatically enroll members with this condition at no charge.

 

Learn more about metabolic health:

Migraine

Our migraine program is made to help members who suffer from severe and recurrent headaches. This program shows the importance of: 

Having a physician to guide your headache management.

  • Identifying trigger.

  • Avoiding triggers.

We automatically enroll members with migraine at no charge.

 

Learn more about migraine:

NICU Case Management

We offer our Neonatal Intensive Care Unit (NICU) Case Management program to support the parents of infants with certain medical needs or conditions. This includes:

  • Complications associated with premature birth.

  • Congenital birth defects.

  • Seizures.

  • Cystic fibrosis.

  • Genetic disorders. 

We provide this service at no charge just for being a member of Healthy Blue. 

 

Learn More: 

Recovery Support

When you or a loved one begins to live healthier, we want you to know you are not alone. We offer a Recovery Support Program for members and their families through care management. Recovery is a process that needs ongoing maintenance. The program will support you throughout every stage of your recovery.  If you would benefit from the recovery support program, call 866-781-5094 (TTY 866-773-9634) to enroll.

Learn more:

Tobacco Cessation

We understand how hard it can be to stop smoking. Nicotine is a highly addictive drug. Many people find they need help quitting tobacco. Our Tobacco Cessation program can help you stop the habit. We provide information, support, and resources to help you become tobacco-free. If you would benefit from the tobacco cessation program, call 866-781-5094 (TTY 866-773-9634) to enroll. You can also get started in the My Health Planner App. 

 

Learn more:

Weight Management

We know that changing your eating and exercise habits can be tough. Americans invest billions of dollars each year in weight-loss diets with no results. So, how do you guarantee results? By making slow and gradual changes that can last a lifetime. That is why we offer our members the Weight Management program. This program will help you make lasting changes that lead to long-term results. If you would benefit from the weight management program, call 866-781-5094 (TTY 866-773-9634) to enroll. You can also get started in our app.

 

Learn more: