When a member is diagnosed with complex health problems, a SummaCare Care Manager monitors the clinical care the member receives.
Care Managers are registered nurses who assist members by helping with transitions between hospital and home or other care settings and helping members access needed health and support services.
Care management services may be short-term for members who are transitioning home after a hospital stay or when a member is new to our plan and needs help finding new doctors within the network.
Care management services may be long-term for members with catastrophic or highly complex problems. For members with complex needs, SummaCare Care Managers will assist in understanding the condition and will coordinate arrangements for complicated plans of care. The SummaCare Care Manager stays in touch with doctors and other caregivers and provides assistance with finding needed care within the plan network.
In the event a SummaCare member reaches the plan limits on certain types of care, a SummaCare Care Manager is available to help the member find other resources.
A Care Manager is available to help SummaCare members arrange for adult care during a transition from child/adolescent needs to adulthood. Our provider search is also available to help find a new provider for someone entering adulthood.
SummaCare’s Care Management programs are available at no cost to you. To learn more about or to enroll in SummaCare’s Care Management Programs, call 330.996.8931 or 877.888.1164 (TTY 800.750.0750) 8:30 a.m. to 5:00 p.m. EST. Enrollment is optional and you may opt out at any time.