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the State of Florida and Nationally. We are here for you. Please click here
to learn how Ultimate Health Plans provides benefits during an Emergency.
Ultimate Health Plans offers many programs to help members manage their health care needs. Members may be referred
to these programs by their physician, an Ultimate Health Plans Care Manager, or a caregiver. Members may also
refer themselves for enrollment in these programs. Ultimate also identifies members who could benefit from these
programs or services based on diagnoses, care that the member needs but has not yet received, or certain evens
such as a recent hospital stay.
Complex Case Management Program
Ultimate Health Plans maintains a Complex Case Management Program for members who may need short-term help after a
recent hospital stay or who have more complex needs, such as when dealing with multiple chronic conditions. For
example, Case Managers can help members transition home or to a skilled nursing facility after a hospital stay,
or work with members who may need extra help with managing multiple medical conditions. Case Managers coordinate
with members and the member’s primary care provider and/ or specialists to review medications, create goals for
members to manage their own health, provide disease or condition-specific education, and assist with making
appointments. Care Managers may also help members address other challenges that prevent them from maintaining
their health by arranging for transportation or making referrals for financial assistance.
Ultimate Health Plans offers several Disease Management Programs to help members who have been diagnosed with any
of the following conditions:
- Heart Failure
- Cardiovascular Disease
- Chronic Lung Disorders
Members enrolled in these programs receive help with managing their conditions. Program services include providing
condition-specific education, setting goals and monitoring progress, help making medical appointments, and providing
referrals to available community programs and services.
Ultimate Health Plans maintains a program to help members at risk for developing Osteoporosis or who have been
diagnosed with Osteoporosis disease. Case managers may assist eligible members by coordinating DEXA scans,
providing educational information, and coordinating with primary care providers for bone-strengthening medications,
Preventive Care and Chronic Condition Management Initiatives
Ultimate Health Plans identifies members who may benefit from certain preventive services, such as flu shots, colonoscopies,
and mammograms, as well as other care to help members manage their chronic conditions, such as diabetic eye exams. Ultimate
may notify eligible members about care for which the member is due but has not yet received, and help the member get the
needed care. Some examples include notifying members about flu shot clinics, help scheduling colonoscopies, arranging for
transportation to a facility for a mammogram, or calling or mailing members to remind them that they are overdue for a
diabetic eye exam.
Once a member is identified as eligible for a Population Health Program, the member is automatically enrolled but may
opt out at any time by calling Ultimate Health Plans. Members may also be disenrolled from a program when they no
longer meet program criteria. If you would like additional information about these programs or to request enrollment
in a program, please call Customer Service between 8 a.m. to 8 p.m. on Monday through Sunday at 1-855-858-7526 or
TTY at 711.