Priority Health’s care management team offers support for members managing chronic kidney disease, diabetes and hypertension.
Priority Health describes this as support from its care management team for members managing chronic kidney disease, diabetes and hypertension. The page is written for members and does not state a line of business or a cost.
What the program is and what members do.
What the program is
The carrier says its care management team can provide support to help members manage chronic kidney disease. The page ties this to diabetes and hypertension as well, and describes it as helping members get the best care possible.
How members use it
Priority Health says to call Customer Service at 888.975.8102 to learn more or get started with a care manager. The page lists what a member gets: connection to resources, help finding an in-network doctor or specialist, guidance through the healthcare system, and education on managing kidney disease, diabetes and hypertension.
What it covers and does not
The support described is education, navigation and resources. The page does not describe treatment, medications, dialysis or any change to benefits, and it does not state outcomes.
Eligibility, funding and plan design.
Who the carrier says it is for
The page does not state eligibility rules or a line of business. It speaks to members managing these conditions. Employers should confirm with Priority Health that it applies to their group.
How it is funded or sold
The page does not state a cost. A related Priority Health care management page says care managers may be available at no additional cost depending on plan type, so we would ask whether that applies here.
Where it fits in plan design
These conditions often occur together, so one care manager route can help a member who is dealing with more than one. It is a support service on top of the medical plan and does not change cost sharing.
What to settle before relying on it.
Is this open to our group at no extra cost?
The page is silent on cost and line of business. We would ask Priority Health for a written answer for the group.
How are members identified?
The page only describes a member calling in. We would ask whether the carrier also reaches out proactively based on claims or diagnosis.
How does this connect to other programs?
Priority Health lists diabetes programs such as Virta and Livongo separately. We would ask how care managers coordinate with them and with the member’s own doctors.
Common questions about this program.
How does a member get started?
The carrier says to call Customer Service at 888.975.8102 to learn more or get started with a care manager.
What does a care manager do here?
Per the carrier, connects members to resources, helps find an in-network doctor or specialist, guides them through the healthcare system and educates them on managing kidney disease, diabetes and hypertension.
Does the page say who is eligible?
No. It does not state eligibility or a line of business, so confirm for your group.
Where these details come from.
This page summarizes what Priority Health publishes. Programs change, so confirm current details with the carrier before relying on them.
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