Coordinated Care Program Overview

Living with a chronic condition can be challenging, however you have the opportunity to receive help managing your condition, so you don’t have to do it alone. Employee Health Plan (EHP) offers over 20 Coordinated Care programs at no extra charge. Additionally, participation in the six voluntary Healthy Choice programs can help you qualify to earn a discount on your health plan premium.

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How the Program Works

Members have regularly scheduled contacts with their Care Coordinator. Care Coordinators help you and your health care providers optimize your health care benefits to meet your health- related needs. Their goal is to educate, coordinate, and facilitate your care needs related to your chronic condition and reduce your risk for serious complications. This program does not replace your physician’s care. It is designed to work with your physician, reinforcing your physician’s recommendations so you can stay healthier between physician visits.

Advantages of Joining the Program

Plan members who join Coordinated Care can be reimbursed for some of their copayments for medically necessary screenings and monitoring equipment. Once all of your Educational and Clinical goals are successfully met, you may be eligible for reimbursement of some of your physician visit copayments.  Medication copays for qualifying condition-related prescriptions, and equipment supplies can be reimbursed 6 months from the date all program goals have been met. Reimbursements and incentives only apply when services are provided by an in-network provider for EHP and EHP Plus plans or Tier 1 provider for Main Campus Residents and Fellows, Florida Residents and Fellows and Martin Hospital Retirees under 65.  The Coordinated Care Incentive FAQ document will provide you with more detailed information on these and other advantages of joining the program.  Upon retirement, members are no longer eligible to participate in Coordinated Care with the exception of Martin Hospital under age 65 retirees. 

EHP members may enroll in any of the Coordinated Care programs listed below:

  • Asthma (adults and children)
  • Congestive Heart Failure (CHF)
  • Depression (adults and children)
  • Diabetes *
  • Hyperlipidemia (high cholesterol) 
  • Hypertension (high blood pressure)
  • Migraine (adults and children)
  • Nicotine Cessation (offered by EHP Wellness)
  • Weight Management (nonsurgical and surgical)

The Employee Health Plan is partnered with AccordantCare, a CVS/caremark company, to provide members with a Rare Disease Management Program that specializes in the uncommon conditions to provide rare or complex care programs.

*See SPD for more information on the Diabetes program and incentives regarding children

These are the six Coordinated Care programs that you may join as part of the voluntary Healthy Choice program:

(They are the only programs that may help you earn a premium discount)

  •  Asthma 
  • Diabetes
  • Hyperlipidemia (high cholesterol)
  • Hypertension (high blood pressure)
  • Nicotine Cessation (offered by EHP Wellness)
  • Weight Management

Related Links

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