How to Get Help Managing Your Care

Dealing with health conditions can be confusing and overwhelming. The medical information you receive may be hard to understand, and instructions from health care providers can be difficult to follow. Do you wish you could have an expert to support and guide you? As a Blue Cross Vermont member, you’ve got one!

Blue Cross Vermont offers confidential, personalized health support services to our members at no charge. A team of nurses and mental health clinicians help you navigate the healthcare system, making sure you get the right treatment at the right time. Our clinicians are also available to answer your questions and help you reach your goals, such as returning to work or managing your health conditions better.

Some areas where we offer personalized health support include:

• Pregnancy and maternal health
• Cancer care
• Chronic conditions like asthma, diabetes, heart disease, and arthritis
• Gender-affirming care
• Mental health conditions
• Substance use disorder treatment and recovery
• End-of-life care

How to Enroll

Any Blue Cross Vermont member can contact us for personalized health support services at any time. Members can request support several ways:

• Call our customer service team using the number on your member ID card
• Call the health support team directly at (800) 922-8778, option 3
• Email the health support team at IHMTriage@bcbsvt.com
• Log into the Member Resource Center and send a secure message to Case Management
• Complete the online referral form

While we encourage members to contact us directly, we also reach out to members who might need support. For example, our clinicians may contact members who’ve stayed in the hospital to offer help in making a smooth transition to home care. Using our personalized health support services is voluntary.

Members seeking pregnancy support can enroll in our Better Beginnings maternal health program in several ways, which are detailed on the Better Beginnings page of our website.

How It Works

Once we receive your request, a health support team member will get in touch by phone to begin the process. They’ll explain what our program offers and ask some questions to get to know you better. The purpose of the questions is to understand what is most important to you. For example, learning which goals you want to work on, such as staying active or getting back to work.    

From there, one of our clinicians will follow-up on what is needed. They might call your doctor’s office to discuss your treatment plan, or they may contact a community program to arrange services for you.

Our clinician will also call you periodically on a schedule that you’ve agreed to. Think of it as a series of conversations designed to get you from Point A to Point B. You’ll be talking with the same person each time, which ensures there are no gaps in support. While most calls take place during business hours from 8 a.m. to 4:30 p.m., we can accommodate after-hours calls if necessary.

The time commitment varies, depending on how much support you need. For some members, one phone call may be enough. Others may need multiple calls spread over several months. Call length could be as short as 5 to 15 minutes, or they could be as long as 45 minutes. Again, it all depends on how much support each member needs or wants.

In addition to phone calls, the clinician may use email to stay in touch. We also have a mobile app which offers secure two-way messaging between a member and the clinician they’re working with. The app also features checklists that provide guidance for members to manage their health, reminders, and a library of educational content.

For more information on our personalized health support services, check out the Help Managing Your Health page on our website.

Results Achieved

How have members benefitted from our personalized health support services? Here are a few examples:

• Prescription assistance: A member was hospitalized because their chronic obstructive pulmonary disease (COPD) had gotten worse. While in the hospital, the member was started on a new inhaler medication. Our clinician showed the member how to apply for manufacturers’ coupons to make the new medication less costly and reviewed how to use the inhaler properly. Our clinician also made sure the member’s primary care physician was following up, and offered further help if the member experienced any problems getting inhaler refills at an affordable cost.
• Outpatient follow-up: When a member with burns suffered during a fire was hospitalized, our clinician ensured they received timely outpatient follow-up care, both from home health and a burn clinic. The clinician also made sure the member had all the prescriptions they needed and knew how to use them properly. Questions the member had about applying for short-term disability were addressed, and our clinician helped the member receive replacements for medical equipment that was destroyed in the fire. With our help, the member was able to return to work without delay.
• Coordinating care: Complex surgery was needed out-of-state for a member. Our clinician worked with other Blue Cross Vermont team members to ensure that the member received guidance and education on benefits and the prior authorization process. Our clinician also coached the member on how to talk to providers about their condition, the care plan, and the cost of care. We coordinated care with out-of-state and Vermont-based physical therapists. As a result, the member got the necessary surgery and post-surgery physical therapy and is on track to achieve their goals for activities.

You’re Not Alone

Whether you’re dealing with an existing condition or facing a new health challenge, as a Blue Cross Vermont member, you’re not alone. If you need personalized health support, please contact us and let one of our experienced clinicians assist you. This free service is included in every Blue Cross Vermont member’s benefits. It’s just one way that we’re making health care work better for Vermonters!