Care management programs

Here for you when you need extra support

Managing your health care can be overwhelming. You might need some extra support coordinating your care and services. We’re here to help. We have no-cost programs to connect you with someone who can help you manage the care and services you already get, plus find even more supports in your community.

Care management can help with:

Understanding your care and treatment options
Learning which benefits you’re eligible for
Learning about your health conditions
Learning about medicines you’re taking
Coordinating your care with all of your providers
Giving support to your family or other people who care for you
Finding community and other services, if you need them
Getting rides to your doctor’s office, if needed

How to get started

If you think these services could help you, call us. Call our Customer Care Center at 1-800-407-4627 (TTY 711) outside L.A. County or 1-888-285-7801 (TTY 711) inside L.A. County Monday through Friday from 7 a.m. to 7 p.m.

Enhanced Care Management

Anthem covers Enhanced Care Management (ECM) services for members with highly complex needs. ECM is a benefit that provides extra services to help you get the care you need to stay healthy. It coordinates the care you get from different doctors. ECM helps coordinate primary care, acute care, behavioral health, developmental, oral health, community-based long-term services and supports (LTSS), and referrals to available community resources.

If you qualify, you may be contacted about ECM services. You or your caregiver can also call Anthem to find out if and when you can receive ECM. Or talk to your healthcare provider who can find out if you qualify for ECM and when and how you can receive it.

This program serves members with the following needs:

Adults and families experiencing homelessness
Adults at risk for avoidable hospital or ED utilization
Adults with serious mental health and/or SUD needs
Adults living in the community and at risk for long-term care (LTC) institutionalization
Adult nursing facility residents transitioning to the community

Covered ECM services

If you qualify for ECM, you will have your own care team, including a care coordinator. This person will talk to you and your doctors, specialists, pharmacists, case managers, social services providers, and others to make sure everyone works together to get you the care you need. A care coordinator can also help you find and apply for other services in your community. ECM includes:

Outreach and engagement
Comprehensive assessment and care management
Enhanced coordination of care
Health promotion
Comprehensive transitional care
Member and family support services
Coordination and referral to community and social supports

To find out if ECM may be right for you, talk to your healthcare provider or call 800-407-4627 (TTY 711).

Changing providers or Lead Care Manager

If you need to change your ECM provider or Lead Care Manager, call the Customer Care Center at 800-407-4627 (TTY 711) to request the change.

Once you have called to change your ECM provider or Lead Care Manager, the change starts as soon as possible but not later than the first day of the next month after your request.

Cost to member

There is no cost to the member for ECM services.

Community Supports

Community Supports may be available under your Individualized Care Plan. Community Supports are medically appropriate and cost-effective alternative services or settings to those covered under the Medi-Cal State Plan. These services are optional for Members to receive. If you qualify, these services may help you live more independently. They do not replace benefits that you already get under Medi-Cal.

If you need help or would like to find out what Community Supports may be available for you, call 800-407-4627 (TTY 711), or call your healthcare provider.