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Accessing Care

Nurse Advice Line is our health information nurse line. It is staffed with Registered Nurses who are ready to answer your health questions 24 hours a day – every day of the year. These nurses have spent lots of time caring for people. Now they are ready and eager to help our members. Contact our Nurse Advice Line at 1-866-807-4490 (TDD/TTY 1-800-955-8770).

You can learn more about your loved one’s health benefits in our Long Term Care Member Handbook (PDF).

Your loved one’s Care Manager is here to support you. They are an important part of the care team, and there are many reasons you may need to contact them. A few examples of instances when you should call your care recipient’s Care Manager:

  • Change in condition
  • ER visit or hospital admission
  • Fall or injury
  • Urinary Tract Infection (UTI)
  • Not all agreed upon services are being provided
  • New diagnosis/medication
  • Assistance with finding a provider or changing providers
  • Difficulty scheduling an appointment
  • Change in living environment or work arrangement for care recipient
  • Need for additional training
  • Durable Medical Equipment (DME) in need of repair or replacement

An emergency situation is when a life could be in danger. It is also when a person could be permanently hurt or disabled without care. Some examples of emergent situations include:

  • Difficulty breathing
  • Severe chest pain
  • Severe bleeding
  • Sudden changes in ability to move, speak, or feel sensations in your arm or leg
  • Poisoning
  • Fainting
  • Sudden mental status changes
  • Coughing or vomiting blood
  • Sudden onset of a severe headache, especially the “worst headache of your life”
  • Suicidal or homicidal thoughts
  • Severe vomiting or diarrhea
  • Behavioral health emergency

Severe injuries also require immediate care. Burns, cuts, extreme joint pain or swelling, and broken bones are all severe injuries. If an emergent situation occurs, the steps below should be followed.

  1. Go to the nearest emergency room. If the member is unable to move and/or it is not safe to move the member, call 911.
  2. After receiving care, our members should always call their doctor within 24 hours and schedule a follow-up visit.

If the condition needs treatment within 24 hours but is not life threatening, visit an urgent care center. If not, call your doctor to receive advice and schedule an appointment.