Clinical

As your trusted partner in health, your well-being is our top priority. More than insurance, we offer many programs and services to help you manage your care needs and live healthy. Call us or complete this member self-referral for care management form to learn more about these programs, ask questions about your coverage or for help to coordinate your care.

All programs are voluntary and confidential, and are available at no extra cost to you.

To learn more about any of the programs and services listed above for you or one of your covered family members, please call us at 888.545.4512

Care management

Experienced registered nurses and licensed social workers provide support, education, and coordination of services for members' complex medical needs including:

Care Management video:

Chronic conditions

We also offer free educational resources and support to members with chronic conditions such as:

  • Asthma
  • Depression
  • Diabetes
  • Heart disease
  • Lung disease

Condition management

We work with members, their families, caregivers, and providers to coordinate care throughout treatment for, and recovery from, complex medical conditions.

Oncology care management

We provide guidance to members diagnosed with cancer to help them understand their benefits, coordinate services, manage treatment-related symptoms, and develop a plan to support their immediate and long-term well-being.

High risk maternity management

We support expecting and new mothers with resources and advice for a healthy pregnancy. In addition, case managers are available for moms and babies with special needs.

Transplant care management

A case manager works closely with the member and the transplant facility to plan pre- and post-procedure care.

Behavioral health care management

The care management team assists with mental health and substance use disorders. We aim to improve the quality of care for members experiencing behavioral health issues by integrating treatment plans, facilitating access to resources, and promoting member engagement in their recovery process.

Meet with a health professional for free at a Capital Blue Cross Connect health and wellness center for:

  • Personal wellness plan development.
  • Health screenings and health risk assessments.
  • Planning for medical procedures and surgery.
  • Nutrition and fitness guidance.
  • Help finding a doctor.

Find a Capital Blue Cross Connect health and wellness center near you.

Our experienced clinical staff provide assistance, education, and resources to help members:

  • Pay for some prescription drugs.
  • Deal with loss of income and/or housing.
  • Find transportation to health care appointments.
  • Deal with loss of health insurance coverage.

Call us at 888.545.4512 to ensure a current care plan continues if you, or a covered dependent, are scheduled for surgery, follow-up treatment, diagnostic study, or are currently receiving services such as: chemotherapy, drug infusions, durable medical equipment, oxygen, radiation treatments or therapy services.

Member self-referral for care management form