MDwise Special Programs

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MDWISE SPECIAL PROGRAMS


MDwise has a number of programs for you and your family. They will help you get healthy and stay healthy. If you have questions about any MDwise programs, go to MDwise.org.

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DISEASE MANAGEMENT


phone-icon.pngMDwise has special resources and tools for members with certain health conditions. These resources and tools are used towards MDwise’s Population Health Management efforts and support our Population Health Management Strategy. We call these resources and tools INcontrol. These resources and tools help with conditions like:
  • Chronic Obstructive Pulmonary Disease (COPD), also called “smokers lung.”
  • Asthma.
  • Diabetes.
  • Heart Disease.
  • Depression.
  • High Blood Pressure.
  • Heart Failure.
  • Autism and other similar disorders.
  • ADHD.
  • Pregnancy (BLUEBELLEbeginnings).
  • Chronic Kidney Disease.
  • Post-Traumatic Stress Disorder (PTSD).

MDwise INcontrol can help you learn more about your condition, and how to best work with your doctor. A MDwise care manager will work with you to help you take care of your condition. You are the most important part of getting better. Actions you take to care for your condition matter the most.
  • You will be walked through basic information about your condition.
  • You will be taught about testing you should get done that you and your doctor may have forgotten about.
  • You will learn steps you can take to prevent your condition from getting worse.
  • You will learn how to take care of yourself.
  • We will help you keep appointments with your doctor.
  • We will help you talk to your doctor about things you learned in the INcontrol program to help you stay INcontrol of your condition.

MDwise members are eligible to participate if they have any of the conditions listed above. We may contact you by telephone, messages, emails or mail. You are automatically enrolled in the program when MDwise receives a claim from your doctor telling us that you have the condition. A MDwise care manager may contact you to begin working with you and your doctor. They will help you follow the doctor’s advice and start you off on a path of being INcontrol of your health.

If you have been newly diagnosed with a condition, or would like to talk to one of our care managers to use these services, please call MDwise customer service.

If you are contacted by one of our care managers and do not wish to participate you can simply opt out of the program at that time. You can also call MDwise customer service.

BLUEBELLEbeginnings is a special program for pregnant members. If you are pregnant and have been told your pregnancy is high-risk, or that you may have complications, please call MDwise customer service. We will ask you a few questions about your pregnancy. This information will be sent to a social worker or nurse who may contact you to offer help with any pregnancy problems.


NURSEon-call


phone-icon.pngSometimes you have questions about your health. Call our 24-hour phone line to speak with a nurse, not a recorded message. Call customer service and choose option #1 and then option #4. If you are a HIP member and NURSEon-call tells you to go to the emergency room you will not have to pay a copay for that visit.


SMOKE-free


phone-icon.pngAre you a smoker, or do you use tobacco in other ways? Do you want to quit? MDwise can help. First, it is very important that you talk to your doctor about quitting. Your doctor can help. There are over-the-counter and prescription medicines that might help you. Many of these are covered. Your doctor can help decide what is right for you. You are also eligible for tobacco cessation counseling services. Your doctor can provide tobacco cessation counseling or refer you to someone else who can. Go to MDwise.org/wellness/smokefree for tools and information to help you quit.

There is a program called The Indiana Tobacco Quitline. They have trained “Quit Coaches” who can help you stop using tobacco. Please call 1-800-QUIT NOW (1-800-784-8669) or go to in.gov/quitline.

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CARE MANAGEMENT PROGRAM


MDwise wants to help you stay healthy. MDwise members may be eligible for Population Health Management services through the Care Management department. Population Health Management is a way we try to help you have better health and quality of life by talking with you, sending you materials or sending you texts about ways to stay healthy. The MDwise care management program can help you manage your health conditions. MDwise care managers help you and your doctor plan for your care. As your needs change, the level of care management will change. Care management will help you become more independent and able to manage your own health care needs. MDwise care managers can help you with mental health and physical conditions.

MDwise care managers can help you make goals for your health. They work with you, your doctors, family and caregivers to do this. They want you to make the best choices for your health. Care managers can help you understand your health conditions and how to best manage them. Care management also assists you with:
  • Understanding your condition.
  • Understanding your medications.
  • Getting supplies and equipment you need.
  • Finding care from special doctors.
  • Getting information about your condition.
  • Scheduling appointments.
  • Talking to doctors about your condition(s) and how you are doing.
  • Getting help from other organizations.

You, your provider, family members or caregivers can all request care management by completing an online referral form or by calling customer service. The online referral form is located at MDwise.org/cmdm-referral and MDwise customer service can be reached at 1-800-356-1204. Once MDwise receives your request, a care manager will contact you and you can discuss your needs or the needs of the person requesting care management. If you agree, we may contact you by telephone, messages, emails, mail or in person (for certain services) to tell you how to use the services. You may also opt out by calling or writing to us.

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RIGHT CHOICES PROGRAM


The Right Choices Program (RCP) is a MDwise care management program for people who need help using their health care benefits. People in the Right Choices Program can be sure to get good health care because each person has a team to help manage their health care.

Who makes up your Right Choices Program team?
  • One primary medical provider (PMP).
  • One pharmacy.
  • A MDwise care manager.
  • You.

The team will help decide when, where, and how you will get medical care.