Individual care to help you control asthma or COPD symptoms.
If you have trouble managing asthma or COPD symptoms, a case manager can really help. You’ll get a customized treatment plan and medicine to:
Let you stay active.
Do you or a loved one have a serious health problem? If so, our case managers are in your corner. They will:
Explain medical terms in plain language.
Coordinate your doctor appointments.
Your case manager will stay with you on your medical journey. He or she will:
Think beyond your medical needs.
Make sure you have support at home.
So you can focus on getting better.
Choice of Doctor
You get to choose a primary care physician (PCP) who is your main doctor. Use the Doctor Lookup tool to see if your doctor is in our network.
If you don’t have a doctor or if your doctor is not in our network, we can help you find a new one close to you.
Your PCP is your main doctor for:
Treatment if you are sick or injured.
Referrals to specialists for certain conditions.
Checkups and dental care are covered for members up to age 21.
Exams and cleanings every six months help teeth and gums stay strong and healthy. If there is a dental problem that needs to be fixed, that’s covered as well.
Equipment and Supplies
Your health and safety at home are important.
Our plan covers medical equipment ordered by your doctor. This can include supplies like:
Walkers or wheelchairs.
Trouble hearing can affect everyday life in many ways. Our plan includes services and support to help protect the hearing of members up to age 21.
Exams, therapy and tests.
Home Meal Delivery
Proper nutrition is essential to good health. Yet you may not be able to safely fix meals for yourself at home. If that’s you, we can arrange for additional meal services.
This plan pays for all expenses related to a hospital stay. This way you can rest and heal.
Our plan covers:
Supplies and equipment.
Treatment and therapies.
Diagnostic tests and exams.
And after you leave the hospital, you are not alone. We make sure you get follow-up care, if needed, to continue healing at home.
Support and personal care where you live, if needed.
Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to help with your appointment.
We also have people at member services who speak more than one language. Chances are, we have someone who speaks your language.
You can get information translated into your preferred language. Just ask. This service is provided at no cost to you.
Our plan includes prescription drugs and refills.
We also cover over-the-counter medicines with a written order from your doctor.
And we make getting your medicine easy. You can fill your prescriptions at:
Local network pharmacies.
Health insurance is complex. Now you have someone you can call. We can answer your questions simply and completely Monday - Friday from 8 a.m. to 5 p.m. local time.
We help you find:
Hospitals or other health facilities.
Mental health is as important as physical health. That’s why we cover both.
Required care is 100% covered with no copay. This includes:
Substance abuse treatment.
Medical questions and situations come at inconvenient times. When you have questions about your health, you can call a trained nurse 24/7.
Our NurseLine nurses will:
Listen to the symptoms.
Guide you on self-care.
Advise you about getting care at a doctor visit or an urgent care center.
Help you know when to go to the emergency room.
Your safety at home is our focus. That is why we conduct home visits for those needing extra help to stay at home.
During this visit we:
Understand your personal needs.
Provide minor home modifications, such as ramps and bathroom safety devices.
Set up emergency monitoring, if needed.
Arrange for personal care attendants.
Do you have family members or friends who care for you at home? If so, we want to support their hard work too. That’s why we provide respite care to give your caregivers a rest. Respite care offers caregivers time away from their loved one who is ill or has special care needs.
Sometimes a person’s health and safety requires help from community programs.
We help members connect to community services. Here they can get information about a variety of programs, like:
Food and housing assistance.
Community child care.
They can help members get much needed relief in many ways.
Our plan provides trips to and from medical appointments.
Our plan offers the exams and lenses that let you see life more clearly.
Members up to age 21 get:
Frames and lenses.
Well visits with your doctor can help keep you healthy. These visits can catch health problems early so they can be treated. Preventive services include:
Checkups for adults.
Routine shots and tests.
You will not have a copayment for preventive care.