How the 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 your health- related needs. Their goal is to educate, coordinate, and facilitate your care needs related to your chronic condition and reduce your risk for serious complications. This program does not replace your physician’s care. It is designed to work with your physician, reinforcing your physician’s recommendations so you can stay healthier between physician visits.Advantages of Joining the Program
Plan members who join Coordinated Care can be reimbursed for some of their copayments for medically necessary screenings and monitoring equipment. Once all of your Educational and Clinical goals are successfully met, you may be eligible for reimbursement of some of your physician visit copayments. Medication copays for qualifying condition-related prescriptions, and equipment supplies can be reimbursed 6 months from the date all program goals have been met. Reimbursements and incentives only apply when services are provided by an in-network provider for EHP and EHP Plus plans or Tier 1 provider for Main Campus Residents and Fellows, Florida Residents and Fellows and Martin Hospital Retirees under 65. The Coordinated Care Incentive 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 with the exception of Martin Hospital under age 65 retirees.
Getting Started is Easy
You can join the Coordinated Care Program by calling EHP Medical Management at 216.986.1050 or 888.246.6648, option 2.
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.
Additional Information
Related Links
Coordinated Care Patient Rights and Responsibilities
