Special Needs Plan: Care Plans - Members

Your Care Plan is developed specifically using the answers you gave us on the Disease Specific Assessment. From those answers you are placed into one of three “tiers”.

Tier 1, Supplemental Tier 1 (Health Appraisal Profile) and Tier 2

Members who are placed in one of these two tiers are managed through Medical Home Office by your Primary Care Physician (PCP). Tier 1 and Tier 2 Care Plans are provided to him/her as a reference document and (along with professional judgment) can be used as a resource tool to help you reach your health goals. The Supplemental Tier 1 (Health Appraisal Profile – HAP) is generated for members who complete and return a Health Assessment Tool (HAT). The HAP includes member-specific responses, identified risk factors and suggested activities to achieve wellness. Members are encouraged to bring the HAP to their PCP for discussion.

Tier 3

Members in Tier 3 are managed through Medical Home Office by your PCP, but this Tier also includes help from a Nurse Case Manager. These Care Plans are developed after further assessment by your Nurse and are shared with you and your PCP. The Nurse will coordinate your care in communication with your doctor(s) and a Social Worker if needed.

Examples of Care Plans

Last updated 10/01/2023