Case Managers: We're Here When You Need Us Most

Tufts Medicare Preferred HMO has programs available to help you get the most out of your healthcare coverage. Did you know that, as a member of Tufts Medicare Preferred HMO, a case manager is available to help you navigate the healthcare system?
 
Our case managers are here when you need them and can help you in many different ways.    
 
What is a Case Manager?
A Tufts Medicare Preferred HMO case manager is a registered nurse who can help you and your caregivers navigate the healthcare system. A case manager also works closely with your physician to help you identify and reach your health goals. Every physician participating in our HMO network works closely with a Tufts Medicare Preferred HMO case manager.
 
What Services Does a Case Manager Provide?
A Tufts Medicare Preferred HMO case manager can assist you in many helpful ways including:

1. Help you gain a better understanding of your healthcare concerns
2. Help you to identify the right time to call your doctor
3. Communicate your health goals to your physician
4. Create a discharge plan for you to leave a hospital or skilled nursing facility
5. Work with you and your family (or caregiver) to make sure you have what you need when you get home from the hospital
6. Help you stay as independent and active as possible in the setting you prefer
7. Identify resources that may help with transportation, or pay for medications and long-term care
8. Help you or your family plan for future needs

Working Behind the Scenes  
Even if you have not met or spoken with a case manager, they are behind the scenes working with your physician to help you receive the best care possible. Case managers frequently connect members to the appropriate Special Population Program. The Tufts Medicare Preferred HMO special population program is for members who may need additional help managing a chronic disease, preventing falls, or managing their medications. Case managers contact members who may benefit from these programs.  
 
Who is eligible to use a Case Manager?
Any Tufts Medicare Preferred HMO member can enlist the help of a case manager. Some members receive calls from a case manager shortly after enrolling in Tufts Medicare Preferred HMO to talk about health risks or to just introduce themselves and let you know they are available if you need them. Other members may have met a Tufts Medicare Preferred HMO case manager while in the hospital or spoken to one of our case managers after returning home about follow up appointments or receiving necessary services or equipment.

How can I find more information on Case Management?
If you have any questions, just call Customer Relations at 1-800-701-9000 (TTY 1-800-208-9562). Representatives are available Monday – Friday, 8:00 a.m. – 8:00 p.m. (From October 15 – February 14, representatives are available 7 days a week, 8:00 a.m. – 8:00 p.m.) After hours and on holidays, please leave a message and a representative will return your call the next business day.