Care Coordination

If you or your child have special or complex health care needs, or have a disability, your PCMP has Care Coordinators who can help. Care coordinators are specially trained health care workers such as registered nurses or social workers. They can help you understand major health problems and set up care with other providers. They can even help you manage appointments with other agencies like DSS or your child's school. A Care coordinator will work with you and your provider to help you get the care you need.

Some examples of members who are helped by Care coordination are:

  • Members who need help with one or more health problems.
  • Members who need help getting basic services like housing and heating assistance.
  • Pregnant Women
  • Members who have cancer.
  • Members who are HIV positive or have AIDS.
  • Foster care children.
  • Members who have diabetes.
  • Members who have sickle cell.
  • Members who have serious mental health problems

Care Coordination can help you with more than just getting healthcare.

Care Coordination can:

  • Help connect you with case and disease management programs.
  • Answer questions about your health.
  • Set up provider visits for you.
  • Set up rides to your medical visits, when appropriate.
  • Set up health screenings for you.
  • Find services in your area.
  • Schedule follow-up care with a specialist if you visited the emergency room.
  • Help you with long-term diseases such as asthma, diabetes, or COPD.
  • Help with pharmacy problems such as prescription refills and prior authorizations.
  • Find resources such as help with electric bills or food stamps
  • Get interpreters if you have hearing impairments or don’t speak English well.

If there are things in your life that are keeping you from getting well, talk to your PCMP. He or she can help. Your PCMP's goal is to help you get well by giving you good medical care and removing barriers to good health.