Care management services for Humana Healthy Horizons in Ohio members
Children and adults with special healthcare needs often can benefit from care management. We offer care management services to all members who can benefit from these services.
Care management services
Care management is a program we make available to eligible members who may need help getting the care they need. If you’re enrolled in a care management program, you can get personalized help from:
- Outreach workers
- Registered nurses
- Social workers
Your care management team will help coordinate your healthcare. This coordination may include helping you find community resources you need.
We may contact you if:
- Your doctor asks us to call you
- You ask us to call you (or ask us if you may qualify for care management services)
- 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 make several care management programs available to our members. Care management programs are options.
Complex care management
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 conditions
- Take multiple medications, served within multiple systems
- Have the highest costs
A team of healthcare providers, social workers, and community service partners work together to help:
- Make sure your needs are met
- Make sure all efforts are made to improve and optimize your overall health and well-being
The complex care management program is optional.
Call our Care Management Support team at 877-856-5702 (TTY: 711), Monday – Friday, 7 a.m. – 8 p.m., Eastern time, to:
- Get information about the complex care management program
- Opt out of the complex care management program
- Self-refer into the complex care management program