The information contained in the links below is presented for the purpose of educating consumers on health and wellness topics, providing general information, and providing tools to assist you in managing your health.
We've discovered something in that wellness is not a destination. It's not some distant finish line that you cross and finally declare yourself "well." Wellness is a practice. It's not something you are, it's something you do. You don't have to be "well" to practice wellness. Anyone can do it, at any stage of life. Even the small choices will help you move toward a better health, whether physical or emotional health-- you are practicing wellness.
Wellness Resources
Health Care Advance Directives
To learn more about your right to use an advance directive, click here.
SmokeFree.gov
For cutting-edge, evidence-based tools designed to help specific audiences quit smoking and remain smoke free.
Smokefree.gov
The American Diabetes Association
The American Diabetes Association helps show you how simple steps can help lower your risk for type 2 diabetes and heart disease in addition to countless resource and information on proper type 1 diabetes management.
Diabetes.org
Diabetes Prevention and Management
Resources to help educate in the prevention and management of diabetes.
Am I at Risk for Type 2 Diabetes?
Keep Your Diabetes Under Control
Medicare Diabetes Prevention Program
The American Dental Association
To learn more on the importance of oral health the American Dental Association has created an award winning website.
Mouthhealthy.org
Additional Resources
Centers for Disease Control and Prevention
CDC.gov
Medicaid Information
Medicaid.gov
Case management
The Case Management Program is a supportive service available to Special Needs Plan (SNP) members. It is designed to address both short-term and long-term health challenges faced by members and their families who are dealing with serious illnesses or acute medical events. This program aims to help navigate the complexities of healthcare systems effectively. Our Case Management team is particularly skilled in addressing a wide range of complex health conditions, including but not limited to:
- Organ transplants
- Cancer treatment
- Frequent hospital admissions
- Major or multiple organ system failures
- Complex wound management
- Fall-related injuries
- Major health concerns
- Medical or surgical cases with complications
- Complex healthcare issues or planning for hospital discharge
- Helping you understand your doctor’s instructions and avoiding unnecessary Emergency Room visits
Participation in the Case Management Program is completely voluntary and does not affect your existing benefits. You have the freedom to opt-in to the program at your convenience, and you can withdraw from it whenever you choose.
Our professional Case Managers collaborate closely with you, your family, and your healthcare providers to develop a personalized Care Plan. They continuously monitor your progress and support you in achieving the goals and outcomes outlined in this plan. Our Case Managers maintain regular communication with your Primary Care Provider to ensure coordinated care.
The goal of our program is to support you in managing your health needs and to help prevent further medical complications. It is crucial that you follow your doctor's advice to maintain your well-being.
We encourage our members to utilize these services. If you have any questions or you are interested in learning more about these services, please call our Member Services department at 1877-336-2069 (TTY users should call 711) and request to speak to a Nurse Case Manager. Member services hours of operation are 8 a.m. to 8 p.m. local time, seven days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September 30.
Transition of care support
After being discharged from the hospital or other health care setting, receiving the right support is essential for a successful recovery at home. While you're still in the hospital, a dedicated Case Manager will assist you in preparing for your return home. It's important that both you and your home caregiver actively participate in the discharge planning process to ensure everyone understands the plan and what to anticipate once you're home.
Key Points to Know Before Leaving the Hospital:
- 1. Expected Discharge Date: Confirm the date you will be leaving the hospital and make necessary arrangements in advance. Ensure you have reliable transportation for that day.
- 2. Post-Discharge Expectations: Understanding your limitations will help you prepare better.
- 3. Home Support Network: Determine who will be available to support you at home. This includes family members, friends, or hired caregivers.
- 4. Daily Needs Management: Plan how you will handle essential daily activities like grocery shopping, cooking meals, and filling prescriptions.
- 5. Emergency Contacts: Have the name and contact number of someone to reach out to if issues arise. Notify your Primary Care Physician (PCP) of your discharge as they will need to know about your recovery plan.
- 6. Identifying When to Call for Help: Understand what symptoms or problems necessitate a call to your healthcare provider. The discharge nurse will discuss these with you.
- 7. Medication Understanding: Gain a clear understanding of your medications before discharge. Know any changes made, why they are necessary, how to take them, and potential side effects. Inform the Case Manager if you have difficulties accessing or affording your medications.
- 8. Discharge Duties: Learn any tasks you'll need to perform at home, such as wound care or bandage changes. Ensure you are comfortable with these tasks. If assistance is required, address this with your doctor or nurse before leaving the hospital.
- 9. Follow-Up Care: Schedule an appointment with your PCP within 7 days after discharge. This follow-up is crucial for reviewing your care plan and monitoring your progress. Know when to report any complications.
- 10. Clear Communication: Be honest with the discharge planner. If any instructions are unclear, communicate this so you can leave the facility with confidence.
After your discharge, a dedicated member of the Health Plan staff will reach out to you by phone. This call is intended to ensure that you fully understand and feel comfortable with your discharge plan. Beyond answering any questions you may have, our staff can facilitate the scheduling of your follow-up appointment with your Primary Care Physician (PCP). Additionally, we offer assistance in coordinating various aspects of your care at home, such as arranging for Durable Medical Equipment (DME), home-delivered meals, and other essential services to support your recovery. Your health and well-being are our foremost priorities, and we are here to support you every step of the way.
Social Services
The Social Services Department is dedicated to assisting you in addressing non-medical needs that may have an impact on your well-being.
The Services Provided Include:
- Telephonic assessments: To evaluate your needs and strengths. It aims to identify resources and support systems.
- Community Resources: Help connecting you to housing, food assistance, financial aid, and other local resources when available.
- Behavioral Health Support: Referrals for counseling or mental health services.
- Member Education: Information on resources to promote self-sufficiency and empower individuals.
We encourage our members to utilize these services. If you have any questions or you are interested in learning more about these services, please call our Member Services department at 1877-336-2069 (TTY users should call 711) and request to speak to a Social Worker. Member services hours of operation are 8 a.m. to 8 p.m. local time, seven days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September 30.
