ConditionCare Is All About You

We're here to help you learn more about your health, keeping you and your needs in mind at every step. Our ConditionCare (CC) programs give you the opportunity to ask questions about your condition, get information about your benefits, and connect you with local resources.

Cómo funciona

 

Our CC staff are here to help you better manage your condition, or health issue, which may improve your quality of life.

 

When you join one of our CC programs, our staff will:

 

 Help you create health goals and make a plan to reach them.

 

 Coach you and support you through one-on-one phone calls.

 

 Track your progress.

 

 Give you information about local support and caregivers.

 

 Answer questions about your condition and/or treatment plan (ways to help health issues).

 

 Send you materials to learn about your condition and overall health and wellness.

 

 Coordinate your care with your healthcare providers, like helping you with:

  • Making appointments.
  • Getting to healthcare provider visits.
  • Referring you to specialists in our health plan, if needed.
  • Getting any medical equipment you may need.

What Programs Do We Offer?

We offer healthcare and support services for members with any of these conditions: 

 Asma

 

 Trastorno bipolar

 

 Cáncer

 

 Enfermedad pulmonar obstructiva crónica (EPOC)

 

 Insuficiencia cardíaca congestiva (CHF)

 

 Enfermedad coronaria (CAD)

 

 Diabetes

 VIH/SIDA

 

 Hipertensión

 

 Major Depressive Disorder — Adult

 

 Major Depressive Disorder — Child and Adolescent

 

 Esquizofrenia

 

 Substance Use Disorder

Asthma is a long-term condition that makes it hard to get air into the lungs. Asthma may cause wheezing, tightness in the chest, shortness of breath, and coughing.

 

We can give you an asthma action plan for you and your healthcare provider to complete. This will help monitor your condition, stay away from your triggers, and manage your medication (meds).

 

Infórmate más (en inglés)

 

Asma

Know Your Triggers 

Asthma Attack 

Asthma Action Plan 

Bipolar disorder is a brain disorder that can cause unusual changes in mood, energy, activity level, and make it hard to carry out day-to-day tasks. 

 

It can feel uneasy to learn you're living with bipolar disorder, so we're here to help. With proper treatment and support, you can enjoy a healthy, happy, and productive life.

Infórmate más (en inglés)

 

Trastorno bipolar

SÍNTOMAS

When to Call a Doctor 

Making care easier when you need it most

 

Managing all the pieces of your care when you’re dealing with ongoing health issues can feel overwhelming. Our Cancer Care Navigator program can help. This program provides a team of nurses and other healthcare providers to help support your care if you have been diagnosed with cancer. We will work with your doctors to simplify the ins and outs of cancer care and make sure you receive the care you need at no extra cost.

 

Plus, the Cancer Care Navigator will connect you to helpful resources. Some of those include a dietitian, help with managing medications, customized care plans, goal setting, and support after hours.

 

Get back time to focus on your well-being with extra support. Learn more about how the program can help you: Call the Cancer Care Navigator team toll free at 833-649-0669 (TTY 711) Monday through Friday, 8 a.m. to 9 p.m. Eastern time, and Saturday, 9 a.m. to 7:30 p.m. Eastern time.

 

Taking part in the program is optional but encouraged. Choosing not to take part in the program does not impact your benefits.

COPD is a condition in which damage to the lungs has caused the airways to change shape and feel partly blocked. This makes it hard to breathe.

 

We can help you learn to breathe easier to possibly improve your quality of life. We'll help you learn how to use inhalers, spacers, nebulizers, and other devices, along with other skills for living with COPD.

Taking care of your heart is one of the best things you can do for your health. The heart pumps blood to the whole body. Having CHF means the heart can't pump as hard as it should.

 

We can help you understand CHF better. That way, you and your health care provider(s) can work together to help you feel your best.

Your heart is only the size of a fist, but it's one of the most important muscles in your body. Arteries throughout the body supply blood to your heart. When those arteries are blocked, and blood flow to the heart is reduced, it causes CAD.

 

We can help you with tips and tools, like making good food choices and following up with your doctor to help you live your best life.

If you're living with diabetes, you're not alone. Diabetes happens when your body's blood sugar (the amount of sugar in the blood) levels are usually higher than normal. It means there's a problem making enough of a hormone called insulin, or your body isn't using insulin like it should.

 

We can help you lower your risk of complications (problems or issues) and make your quality of life better.

Human immunodeficiency virus (HIV) is a virus that attacks the immune system (the body's natural defense against illness). It makes it hard for the body to fight infection and disease. If HIV isn't treated, it can lead to AIDS. AIDS stands for acquired immunodeficiency syndrome. It is the last stage of the HIV virus.

 

We're here to help you with simple steps for living with HIV/AIDS. Taking your medications the right way, eating healthy, staying active, and following your treatment plan can make a difference.

Hypertension is also called high blood pressure. Blood pressure is the amount of force it takes for your heart to pump blood through your body. When your blood pressure is high, it can lead to other health problems.

 

We can help you make short- and long-term goals that will help you manage your blood pressure.

Everyone feels blue or sad some of the time, but these feelings don't last very long. When a person has major depressive disorder (MDD or clinical depression), these feelings don't go away easily. They can get in the way of your everyday life.

 

Depression is common and a real illness. The important thing to know is that it can be treated. We're here to help you find resources in your area or help you talk with your family or caregiver about MDD.

Infórmate más (en inglés)

 

Depresión

Symptoms of Depression 

Kids and teens can also have major depressive disorder (MDD or clinical depression).

 

We can help kids and teens talk with their families and healthcare providers about MDD, get treatment, and live a healthier life.

Infórmate más (en inglés)

 

Depression in Children and Teens 

Schizophrenia is a behavioral health disorder that affects a person's thoughts, feelings, emotions, decisions, and actions. Some even have a hard time with focusing and memory loss. It can get in the way of daily life.

 

We’re here to help you learn how to manage schizophrenia with medication, treatment, and support.

Substance use disorder is a disease that leads to the use of drugs, alcohol, or other substances in a way that causes problems for your health or in your life.

 

We can help those with substance use disorder work together with their healthcare provider(s) to talk about treatment options (choices of ways to get better) and finding local community programs and resources.

Infórmate más (en inglés)

 

Substance Use Disorder 

Tratamiento

For Family and Friends 

When to Call a Doctor 

 

We’re here to help walk you through your treatment plan and provide resources to help support you.

Who Can Join?

Any Anthem member with any of the health conditions listed can participate in a CC program. Our CC case manager can talk with you about your health history, health goals, and work with you to offer strategies and support so you can live well.

 

They can also offer educational materials and tools for weight management and tobacco cessation (how to stop using tobacco, like quitting smoking).

How To Join

 

Members, you’ll get a letter welcoming you to a CC program, if you qualify. You also can call us toll free at 888-830-4300 (TTY 711) from 8:30 a.m. to 5:30 p.m. Eastern time Monday through Friday.

When you call, we’ll:

 

  • Set you up with a CC case manager to get started.
  • Ask you some questions about your or your child’s health.
  • Start working together to create your or your child’s plan.

 

You can also email us at: ConditionCare-self-referral@anthem.com .

Please be aware that emails sent over the internet are usually safe, but there is some risk third parties may access (or get) these emails without you knowing. By sending your information in an email, you acknowledge (or know, understand) third parties may access these emails without you knowing.

 

You can choose to opt out (we’ll take you out of the program) at any time. Please call us toll free at 888-830-4300 (TTY 711) from 8:30 a.m. to 5:30 p.m. Eastern time Monday through Friday to opt out. You may also call this number to leave a private message for your CC case manager 24 hours a day.

ConditionCare Rights And Responsibilities

When you join a ConditionCare (CC) program, you have certain rights and responsibilities. Tienes derecho a:

 Get details about us, such as:

  • Programs and services we offer.
  • Our staff and their qualifications (skills or education).
  • Any contractual relationships (deals we have with other companies).

 

 Opt out of CC services

 

 Know which CC case manager is handling your CC services and how to ask for a change

 Get support from us to make health care choices with your healthcare providers

 

 Ask about all CC-related treatment options (choices of ways to get better) mentioned in clinical guidelines (even if a treatment is not part of your health plan), and talk about options with treating healthcare providers

 

 Have personal data and medical information kept private

 Know who has access to your information and how we make sure your information stays secure, private and confidential

 

 Receive polite, respectful treatment from our staff

 

 Get information that is clear and easy to understand

File complaints/grievances to Anthem by calling 888-830-4300 (TTY 711) toll free from 8:30 a.m. to 5:30 p.m. Eastern time Monday through Friday and:

  • Get help on how to use the complaint/grievance process.
  • Know how much time Anthem has to respond to and resolve issues of quality and complaints/grievances.
  • Give us feedback about the CC program.

You Also Have A Responsibility To:

 

 Follow the care plan that you and your CC case manager agree on.

 

 Give us information needed to carry out our services.

 

 Tell us and your healthcare providers if you choose to opt out (leave the program).

 

For a written version of your CC rights and responsibilities or information on this website, please print this page or call Member Services.

 

Marketing Statement:

 

ConditionCare does not market products or services from outside companies to our members. CC does not own or profit from outside companies on the goods and services we offer.

Useful Phone Numbers

En caso de emergencia, llame al 911.

Atención de afecciones

Leave a private message for your CC case manager 24 hours a day. Toll free: 888-830-4300 (TTY 711) Monday through Friday 8:30 a.m. to 5:30 p.m. Eastern time

Nurseline 24/7, línea gratuita de enfermería

After-hours: Call 24/7 NurseLine 24 hours a day, seven days a week 844-430-0341 (TTY 711)

 

Healthy Families

Healthy Families is a six-month program for members ages 7-17. The goal of the program is to help families form healthy eating habits and become more active. For kids who qualify, parents will get one-on-one coaching phone calls with us to:

  Create health goals just for your child that are clear and that they can meet.

 

  Make a plan to reach those goals.

 

  Talk about getting and staying active and healthy food choices.

 

  Help find resources to support a healthy life in your area.

 

  Find out if your health plan has extra benefits to help with living a healthier life.

 

Learn More And Join

Give us a call at 844-912-0938 (TTY 711)

 

Monday through Friday from 8:30 a.m.–5:30 p.m. Eastern time to find out more about the program.

 

We’ll ask you some questions about your child’s health to see if they qualify.