Case Managers provide Members with a coordinated, personalized care team

If you need help managing a medical problem or chronic condition, such as diabetes, a Case Manager can help you. A Case Manager is a nurse or other health care professional who helps you get the medical care and other services you need to manage your condition.

Your Case Manager can assist in completing your Health Risk Assessment (HRA), schedule your complete, in-person exam or other needed appointments, and assist with other Member needs.

They can help you:

  • Get answers to your questions about your medical condition
  • Make appointments with all your doctors
  • Get rides to your medical appointments (if needed)
  • Schedule interpreter services for you medical appointments (if needed)
  • Get medical supplies and equipment you need
  • Understand the medicines you take
  • Help you transition from one setting to another, such as from a hospital back to your home
  • Find community resources that offer services you need, such as "Meals on Wheels"
  • Work with your caregiver to make sure they have what they need for your care

You can work directly with your care team to assist with your care needs. Your Case Manager can also work with your family or friends who help you with your health care needs.

Best of all, there is no charge for these services. Everything is covered by your Cal MediConnect Plan.

While a Case Manager will automatically be assigned, there are many ways you can be referred to our Case Management program. You can be referred to this program through:

  • Your provider
  • Your personal doctor
  • Your specialist
  • Member Services

You can also do a self-referral to this program by calling Member Services.

To participate in the program you must meet certain requirements. This program is available at no cost to you.

For more information about your Case Manager, please see Chapter 2 of your Member Handbook.