Care management services for Humana Healthy Horizons in Ohio members

Humana Healthy Horizons in Ohio offers care management services. Children and adults can benefit from care management. We offer care management services to all  members who can benefit from this service regardless of age and based on your individual needs. Care management services are voluntary, free of charge, and you can stop services at any time.

Members can self-refer, too. We have registered nurses, social workers, and other outreach workers  who can work with you one-on-one to help coordinate your health care. This coordination may include helping you find community resources you need

 Care CoordinatorsWe may contact you about care management services  if:

• Your  doctor asks us to call you
• You ask us to call you 
• Our staff feels this service may be helpful to you or your family 

Care management services can: 

• Answer questions about what your medicines do and how to take them
• Connect you to helpful resources in your community
• Coordinate your appointments and help arrange for transportation to and from your doctor
• Follow up with your doctors or specialists about your care
• Help you continue to receive the care you need if you switch health plans or doctors
• Help you set and reach your goals to better manage your ongoing health conditions
• Help you figure out when to get medical care from your primary care provider, an urgent care or retail center, or an emergency room (ER)

We will work with a variety of partners including your doctors, and other supports in the community 38 Member Services: 877-856-5702 | TTY: 711 to make sure you have everything you need to improve your health and wellbeing. We will ask about your specific current health and past health as well as your environment to develop a plan we can follow to keep you on a healthy journey. If you have any questions, would like to participate in care management or need help, call member services at 877-856-5702 (TTY: 771)

We make  specialty care management programs available to our members. Care management programs are optional. , free of charge and you may stop at any time.

Humana Healthy Horizons® in Ohio members may be eligible to get complex care management services if they:

• Experience multiple hospitalizations, and/or 
• Have complex medical needs that require frequent and ongoing assistance

Complex care management provides support to members with complex clinical, behavioral, functional, and/or social needs, who:

• Have the highest risk factors, such as multiple health conditions
• Take multiple medications 
• Served by multiple providers 
• Often have higher costs

 A team of healthcare providers, nurses, social workers, and community service partners are available to make sure your needs are met, and efforts are made to improve and optimize your overall health and well-being. This team will be led by a Case Manager who coordinates and support your care needs:The complex care management program is voluntary, free of charge and you may opt out at any time by speaking with your Care Manager

To get additional information about our Complex Care Management Program, self-refer into any of our Care Management Programs, or opt out of any of our Care Management Programs, contact our Member Services team at 877-856-5702 (TTY: 711) HumanaBeginnings Program

Our HumanaBeginnings program helps our pregnant members during and after pregnancy. We  tailor this program to each of our pregnant members, to make sure they get the care they need, like extra support from a nurse, pregnancy and family-planning resources, and connects members with additional plan benefits such as gift cards. Call member services at 877-856-5702 (TTY: 711) to learn more and to enroll into HumanaBeginnings program

Care Transitions

If you are hospitalized, our care managers can help you before you leave the hospital. We can:

• Answer any questions you may have about getting out of the hospital
• Answer questions about the drugs your doctor gives you
• Help arrange your doctor visits
• Help set up support for when you get home
• Assist you if you transition between health insurance plans

If you or your family member needs help when you get out of the hospital, or if you need help transitioning back to your home from other places where you were treated, please let us know. You  can reach us by calling member services at 877-856-5702 (TTY: 711).

Chronic Condition Management

Humana Healthy Horizons in Ohio provides members with chronic conditions care support that  includes educational information, goal setting, and coordination support for doctor visits. These care services help members to address potential complications, avoid complications, and maintain their health. We can help you learn about your condition and how you can better take care of your health. We have programs for:

• Asthma
• Bipolar Disorder
• Chronic Obstructive Pulmonary Disease (COPD)
• Diabetes
• Heart Disease
• HIV/AIDS
• Hypertension
• Schizophrenia

We can:

• Help you understand the importance of controlling the disease
• Give you tips on how to take good care of yourself
• Encourage healthy lifestyle choices

To get additional information about our Care Management Program, self-refer into any of our Care Management Program, or opt out of any of our Care Management Programs, contact our Member  Services team at 877-856-5702 (TTY: 711).

Help with Problems Beyond Medical Care

It can be hard to focus on your health if you have problems with your housing or worry about having enough food to feed your family. Humana Healthy Horizons in Ohio can connect you to resources in your community to help you manage issues beyond your medical care. This includes concerns such as:

• Worry about your housing or living conditions
• Have trouble getting enough food to feed you or your family
• Find it hard to get to appointments, work, or school because of transportation issues
• Feel unsafe or are experiencing domestic violence (call 911, if you are in immediate danger)

If you need assistance with these issues contact our member services team at 877-856-5702 (TTY:711)