FAQ: Care SElect

What is Care Select?

The Care Select program is a disease management program.  Disease management is a system of coordinated health care interventions and communications for members with chronic health conditions. This new program will help members with chronic conditions such as asthma or diabetes better manage their disease.

What conditions are covered in the Care Select program?

Members with the following conditions will be eligible for the disease management program:

  • Asthma
  • Diabetes
  • Heart Failure
  • Congestive Heart Failure
  • Hypertensive Heart Disease
  • Hypertensive Kidney Disease
  • Rheumatic Heart Illness
  • Severe Mental Illness
  • Serious Emotional Disturbance (SED) for Wards and Fosters
  • Depression

How will disease management assist me?

Disease management offers members with chronic health conditions assistance with understanding and taking care of their health.  The disease management program will offer educational information, access to nurses and other health care professionals, and assistance with finding providers.

Can I apply for Care Select?

You do not specifically apply for Care Select. To qualify for the Care Select program, you must be diagnosed with a qualifying disease. You must enroll or be enrolled in Medicaid and meet other eligibility requirements.

Your doctor can report your disease to the enrollment broker. If you meet other eligibility requirements and you choose to opt in to the Care Select program, you then need to call the enrollment broker to select an affiliated doctor. The enrollment broker then enrolls you in the Care Select program. If you qualify for Care Select, but do not wish to be in Care Select, you may opt out of the program and choose to be in Traditional Medicaid instead.

  • MAXIMUS (enrollment broker): 1-866-963-7383

How is my health plan determined?

You are able to select a Primary Medical Provider (PMP) and health plan of your choice. If you do not proactively choose a PMP one may be selected for you.

Are there PMPs in Care Select?

Yes.  In Care Select, you will select a PMP and a Care Management Organization (CMO). Your CMO will be based on the PMP you selected.

How can I change my PMP?

To change your PMP, please call your health plan or the enrollment broker. The telephone numbers for the health plans and the enrollment broker are:

  • ADVANTAGE: 1-800-784-3981
  • MDwise: 1-800-356-1204 or 317-630-2831 in Indianapolis
  • MAXIMUS (enrollment broker): 1-866-963-7383

How long does it take to change my Primary Medical Provider (PMP)?

Changes within the health plan usually take 3-5 days. Changes between health plans generally take 30-45 days in order to become effective.

Is it true that I can go to ANY doctor as long as that doctor accepts Care Select or Medicaid?

No. Care Select members must select a PMP that accepts Care Select.  You can see any other doctor that accepts Medicaid for your other health needs.  If you don't already have a PMP, call the Helpline for assistance at 1-866-963-7383. This is a free call.

What if I need medical attention and my doctor's office is closed?

Make sure you get the number where you can reach your doctor after hours for health care services. A qualified medical professional is available to you 24 hours a day to give you medical advice and tell you what you should do in each situation. Often your doctor's office will provide a 24 hour contact number when their office is closed. Never go to the emergency room unless you have a true emergency. True emergencies are when a delay in treatment would result in lasting injury or death. Some examples are chest pain, broken bones, and bleeding that cannot be stopped.

What do I do if I need to miss or have missed a doctor appointment?

If you need to miss a scheduled appointment with a provider, you need to call the doctor's office as far in advance as possible. Most offices consider 24-48 hours notice as acceptable. If you remember that you have missed an appointment after the appointment, you should call your doctor's office to apologize, explain why the appointment was missed, and reschedule.

How can I request a new Medicaid card?

If you need to request a new card, please call or visit your caseworker. If you do not have a caseworker, call 1-800-403-0864.

How can I change my address?

It is very important that you keep your address updated. If you change your address, please call or visit your DFR caseworker. If you do not have a caseworker, call your local Division of Family Resources Office.

I need an Authorized Representative Form.  Where can I find it?

You can find that form by clicking on the Authorized Representative Form found in the Forms Library found under the Resource Center.

How do I file a complaint?

If you have a complaint or grievance regarding your PMP or health plan, you need to call your health plan. The telephone numbers for the health plans are:

  • ADVANTAGE: 1-800-784-3981
  • MDwise: 1-800-356-1204 or 1-317-630-2831 in Indianapolis

If you do now know which health plan you belong to, contact the Helpline at 1-866-963-7383. This is a free call.

Are Home and Community Based Services (HCBS) waiver recipients eligible for Care Select?

No. HCBS waiver recipients are not eligible for the Care Select program, even if you have one of the included chronic conditions.  HCBS waiver recipients are eligible for case management under the waiver, which is similar to disease management.

What if I don't want to participate in disease management?  Will I still have coverage?

You will be able to opt out of the disease management program, if you prefer.  Medicaid coverage and benefits are the same for members in the disease management program and members who are not in the disease management program.  Members in the Care Select disease management program will have access to additional educational resources.

Can a member choose to not be in Care Select?

Yes, once you are enrolled in the program, you can choose not to participate or "opt out" of Care Select at any time.  If you choose to opt out of care select, you must contact the enrollment broker, MAXIMUS, at 1-866-963-7383.  The change will be effective in five business days. Once you opt out of Care Select, you will continue to receive Traditional Medicaid benefits.

Will I be able to see my current PMP if I move from Care Select?

If you move from Care Select, you will be in Traditional Medicaid.  You will be able to see any Indiana Medicaid provider.  It is good to keep going to a doctor that is familiar with you and your health conditions.