Blue Cross and Blue Shield of Texas provides voluntary condition management programs designed specifically for those who have been diagnosed with asthma, diabetes, congestive heart failure, coronary artery disease, metabolic syndrome (high blood pressure, high cholesterol), lower back pain or end stage renal disease. When you enroll in one of the programs, you'll receive helpful information about your condition, at no out-of-pocket cost to you.
Condition management programs work together with your health plan, doctor and you to help identify the best way to manage your condition more effectively. Enrolling in a program can help:
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Decrease the intensity and frequency of your symptoms
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Enhance your self-management skills
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Minimize missed days at work
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Enrich your quality of life
Claims and pharmacy data review, preauthorization prior to a hospitalization or a physician referral are some of the factors that help determine if a condition management program is right for you. Blue Cross and Blue Shield of Texas will notify your doctor by letter if it finds that you would benefit by enrolling in a program. Each program addresses your specific needs, based on the severity of your condition, complications and risk factors. If the severity of your condition is mild, you will receive:
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Coverage for targeted preventive screenings
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Seasonal mailings with educational materials related to your condition
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Annual contact calls to encourage medication compliance
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Tools to help you better self-manage your condition
If the symptoms of your chronic condition are moderate to severe, your program will be tailored to provide you with:
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Personalized self-management planning
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Regularly scheduled monitoring by a registered nurse
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24-hour-a-day telephone access to a specialty nurse
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An audio library of topics related to your condition, available by telephone around-the-clock
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Assistance in getting durable medical equipment covered under your health plan
Call 1-800-462-3275 to enroll or to find out more about how condition management programs can help you.
