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What is Care Management?

Whether you are looking for wellness, want to maintain health or are dealing with a more serious condition, our team of registered nurses, licensed social workers, and behavioral health specialists can help you manage your health and coordinate care. This is a confidential, voluntary program provided at no additional cost to help you stay healthy!

To learn more, you or your provider may call us at 888.545.4512 (TTY: 711) from 8:00 AM to 8:00 PM ET, Monday through Friday.

Our programs may help, if you:

  • have been diagnosed with a serious medical condition.
  • have multiple injuries or medical problems.
  • are at risk for a future serious health problem due to a current one.
  • have been in the hospital.
  • are seeing several doctors.
  • may need an organ transplant.
  • have a condition that makes it hard or impossible to take care of yourself.

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Programs

These are just some of the care management programs available to support your needs:

Catastrophic and Complex needs, including but not limited to: Connective Tissue Disorder, ESRD (End Stage Renal Disease), Renal Failure, Lung Disease, Oncology, Trauma, Transplant, Multiple Sclerosis, and more.

Chronic Conditions such as asthma, diabetes, coronary artery disease, chronic obstructive pulmonary hypertension, heart failure, hypertension, low back pain, rheumatoid arthritis, chronic kidney disease Crohn’s disease, and more.

Transition of Care (leaving a facility of care, hospital admission or discharge)

Behavioral health needs including serious mental illness, substance use disorder, and peer recovery.

Social Work Needs for navigating insurance, financial and community resources.

The care management team assists with mental health and substance use disorders. We aim to improve the quality of care for members experiencing behavioral health issues by integrating treatment plans, facilitating access to resources, and promoting member engagement in their recovery processes.

Call us at 888.545.4512 to ensure a current care plan continues if you, or a covered dependent, are scheduled for surgery, follow-up treatment, diagnostic study, or are currently receiving services such as: chemotherapy, drug infusions, durable medical equipment, oxygen, radiation treatments or therapy services.

Our resources

Want flexibility in how and when you like to explore resources, learn, and receive support in your health journey?

These programs offer outstanding information and tools.

  • Pre-diabetes
  • Diabetes care
  • Diabetes reversal - if you have Type 2 diabetes

View our diabetes programs to learn more.

The Capital Blue Cross Medicare Advantage Continuity of Care program helps eligible members remain under the care of a current provider when under an active course of treatment.

The Continuity of Care program allows members to continue care with their current healthcare provider in certain situations. Please see the Continuity of Care form for additional information about the program and how Capital can support this transition. For questions on this form, or to discuss the options available to you, please reach out to Member Services.

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Call us at 888.545.4512 to ensure a current care plan continues if you, or a covered dependent, are scheduled for surgery, follow-up treatment, diagnostic study, or are currently receiving services such as: chemotherapy, drug infusions, durable medical equipment, oxygen, radiation treatments or therapy services.

Member self-referral for care management form

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Updated October 1, 2025

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