How the Care Coordinator Program Works
Members have regularly scheduled contacts with their Care Coordinator. Care Coordinators help you and your health care providers optimize your health care benefits to meet health-related needs.
Their goal is to educate you, discuss lifestyle changes necessary to meet your goals, review your progress and refer you back to your provider as needed for your care needs related to your health condition and reduce your risk for serious complications.
This program does not replace your provider's care. It is designed to work with your provider's recommendations so you can stay healthier between provider visits.
Advantages of Joining the Care Coordinator Program
Plan members who join the Care Coordinator Program are eligible to earn a premium discount by participating in their identified Track(s) for the Healthy Choice Program through the Coordinated Care team. Additionally, members can also be reimbursed for some of their copayments for medically necessary screenings and monitoring equipment.
Once all of the goals for your Track(s) are successfully met, you may be eligible for reimbursement of some of your provider visit copayments, along with qualifying condition-related prescriptions and equipment supplies. Reimbursements and incentives only apply when services are provided by an in-network provider for EHP and EHP Plus plans.
The Coordinated Care Copay Reimbursement FAQ document will provide you with more detailed information on these and other advantages of joining the program. Upon retirement, members are no longer eligible to participate in Coordinated Care.
Below are the five premium discount Care Coordinator Program Tracks that you may join as part of the voluntary Healthy Choice Program:
- Asthma Track
- Diabetes Track
- Hyperlipidemia Track
- Hypertension Track
- Weight Track
For additional details about the Care Coordinator Program, please refer to this FAQs document.
Getting Started is Easy
You can join the Care Coordinator Program by calling EHP Medical Management at 216.986.1050 or 888.246.6648, option 2 or by logging into your Healthy Choice Portal.
Coordinated Care Copay Reimbursement FAQ
At this time, anti-obesity medications are not reimbursable under the medical reimbursement program. For more information, see the Prescription Drug Coverage section of our FAQs.
AccordantCare
The Employee Health Plan is partnered with AccordantCare, a CVS Caremark company, to provide members with a Rare or Complex Condition Program that specializes in the uncommon conditions to provide rare or complex care programs.
More information can be found here.
Related Links
Coordinated Care Member Rights and Responsibilities
