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Care Coordination

For our members with high-risk health issues, BCBSMT has designed the Care Coordination program to help improve health outcomes and quality of life. Our Registered Nurses and Behavioral Health Specialists help by identifying individual needs and maximizing plan benefits for members.  

Care Coordinators are here to assist you by supporting physicians’ treatment plans and helping you to navigate through the health care system.  Care Coordination will be your one-stop connection at BCBSMT for health or benefit questions, education, support, and health strategies.

Care Coordinators provide resources to help you deal with the effects of chronic or diagnosed conditions including but not limited to those listed below:

 High-Risk Maternity High-Risk/HighCost Illness  High-Cost Procedures  Other
  • History of preterm labor
  • Including but not limited to women who may be at high risk for preterm labor
  • Other medical issues in pregnancy
  • Birth defects
  • Bleeding disorders
  • Cancer
  • Cardiac problems
  • Child with chronic medical issues
  • Diabetes with complications
  • Head or brain injuries
  • Kidney disease
  • Long-term rehab
  • Major burns
  • Major trauma
  • Spinal cord injuries
  • Stroke
  • Brain/spinal cord surgeries
  • Covered obesity surgeries
  • Dialysis
  • Heart surgeries
  • Left Ventricular Assistive Device (LVAD)
  • Organ transplants
  • Care needed by multiple physicians
  • Complications after surgery
  • Complications of medical treatment
  • Disease affecting multiple organs
  • Educational needs
  • High-cost DME items
  • Multiple ER visits
  • Outpatient chronic pain programs
  • Readmission to a hospital within 15 days of discharge

Mental Health Diagnoses

Including but not limited to Autism, Bipolar Disorder, Chemical Dependency, Eating Disorders, Major Depression, Panic Disorder, Obsessive-Compulsive Disorder, Schizoaffective Disorder, Schizophrenia, or Suicidal Ideation

Long-term Medical Conditions

  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Congestive Heart Failure (CHF)
  • Coronary Artery Disease (CAD)
  • Diabetes
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