Special health programs

AmeriHealth Caritas Louisiana has special programs to help you stay healthy. You do not need a referral from your PCP to be a part of any of these programs. If you have one of the health conditions listed below, you could become a part of one of our special programs.

For a full list of special health programs you can join as a member of AmeriHealth Caritas Louisiana, see your member handbook.

How can I become a member of one of these programs?  

  1. Log in to the member portal and go to Enroll in a Special Program.
  2. You can ask by calling care management at the number listed below.
  3. Your primary care practitioner (PCP), specialist, or other health care provider may also talk to you about becoming a part of the program. He or she will call us to have you join.
  4. We may see from your health history that you might benefit from the program. We will send you information in the mail or call you about becoming a member.
As an AmeriHealth Caritas Louisiana member, you can say you do not want to be a part of these programs. You can tell us on the phone or in writing. If you decide you do not want to be a part of these programs, it will not change your benefits. It will also not change the way AmeriHealth Caritas Louisiana or Louisiana Medicaid treats you. 
  
If you have any questions about our special care management programs, or do not want to be a part of these programs, please call us at 1-888-756-0004 (TTY: 1-866-428-7588), 24 hours a day, seven days a week.

These special programs are available to you:

Bright Start®

Early and complete health care before your child's birth is the key to having a healthy baby. Bright Start® by AmeriHealth Caritas Louisiana helps moms-to-be make healthy choices for themselves and their unborn baby. Any member who is pregnant can join the Bright Start program at no cost.

Your health care provider will decide if your pregnancy is "low risk" or "high risk." If the pregnancy is low risk, you will talk to a Bright Start Outreach Coordinator about your needs, services, and classes you may attend. When you join Bright Start and are high-risk, a case manager will call you and work with you to receive and use program services. The Bright Start Outreach Coordinator will help you choose an AmeriHealth Caritas OB/GYN and a PCP for your baby. They will also mail information to you during your pregnancy.

With the Bright Start program, we can:

  • Help you sign up for childbirth and other health information classes.
  • Help you choose a doctor who is right for you.
  • Give you information on prenatal vitamins and eating right; your body needs extra vitamins, like folic acid (a B vitamin), when you are pregnant.
  • Work with your provider and dentist to make sure you get the care you need; having healthy teeth and gums is very important during pregnancy.
  • Give you information and resources to help you have a safe pregnancy and a healthy baby.

Your pregnancy may be high-risk if:

  • You are under 18 years old
  • You had a problem pregnancy in the past
  • Your doctor tells you that your pregnancy is "high risk”

Each Bright Start high-risk member works with a special nurse. The nurse will give you information about your needs, help you get the care you need, and check in with you often to help you during your pregnancy. The nurse will work with you to get special services you may need including social work, specialty care, home health services, or help from local agencies.

After your baby is born, the Bright Start Outreach Coordinator will talk with you to help you get health services for your baby.

To join or opt out of Bright Start, please call 1-888-913-0327, Monday through Friday, from 8 a.m. – 5 p.m. Or you can log in to the member portal and go to Enroll in a Special Program.

If you decide you do not want to be a part of these programs, it will not change your benefits. It will also not change the way AmeriHealth Caritas Louisiana or Louisiana Medicaid treats you.

Check out our Bright Start Plus mobile app

Track your pregnancy through each milestone and trimester. Create profiles for the whole family. Read about health milestones for mom and dad, adults and kids. Track health milestones for everyone.

Learn more about our Bright Start Plus mobile app

Care Management

AmeriHealth Caritas Louisiana has special programs to help you stay healthy. You do not need a referral for any of these programs. If you have one of the conditions listed below, you could become a part of one of our special programs.

These programs will help you understand your condition better. These programs will educate and help you manage your condition and improve your quality of life. A case manager will assist you with your care and send you information about your condition. A case manager will also reach out to you by phone to find out how you are doing and work with you to receive program services.

Sickle cell anemia

Sickle cell anemia is a blood disorder a person is born with. When you have sickle cell anemia, some of the blood cells in your body are not a normal shape. These cells can block blood flow and cause pain.

The sickle cell anemia program will help you learn about getting care and how to decrease pain. The program will also help you learn about the risk of having a stroke and how important it is to get your immunizations (shots).

Human Immunodeficiency Virus (HIV)

HIV is a virus that causes acquired immune deficiency syndrome (AIDS). The state of Louisiana is one of the highest-ranking states with the greatest number of people who have a diagnosis of HIV in the United States.

The HIV program is nonjudgmental and will help you learn about taking care of yourself. You will be treated with dignity and respect while developing a relationship with the Care Manager, who is a registered nurse, to help you learn about the disease. All of your medical information will be protected.

The goals of the HIV program are to:

  • Help you stay healthy by sustaining a low viral load (less than 200copies/ml)
  • Help you understand the different tests and screenings
  • Help to teach adherence to the Antiretroviral Therapy (ART) medications
  • Keep you out of the hospital
  • Help you find needed resources in the community

Hepatitis

Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV). Hepatitis C infection often does not have any symptoms. Chronic infection can lead to cirrhosis of the liver which is scarring of the liver. This may lead to other serious diseases like liver failure or liver cancer.

The Hepatitis C program focuses on helping patients to:

  • Understand and manage medications
  • Improving adherence to medication regimen
  • Provide information about recommended vaccinations
  • Improving self-management
  • Helping to understand behavioral risk

Asthma

Asthma is a long-term illness that makes the airways in your lungs swollen and blocked. When you have asthma, the tubes that carry air in and out of your lungs can become narrow or filled with mucus. This makes it hard to breath. Certain triggers, like dust, pollen or smoke can make this happen.

Asthma can be controlled. The Asthma program at AmeriHealth Caritas Louisiana will help you learn about the medicines and equipment that help keep asthma in control.

COPD

Chronic obstructive pulmonary disease (COPD) is a lung disease that damages one or both of your lungs. When you have COPD, the tubes that carry air in and out of your lungs are partly closed, which makes it hard to breathe.

  • Shortness of breath, especially with physical activity.
  • Continuous cough, especially if there is a lot of mucus or phlegm.
  • Chest tightness.
  • Wheezing (a whistling or squeaky sound when you breathe).

Cigarette smoking is the most common cause of COPD. If you would like to quit smoking, please call the Louisiana Quit Line at 1-800-QUIT-NOW (1-800-784-8669). Talk to your doctor about medicines that can help you quit.

Diabetes

People with diabetes have too much sugar in their blood and/or not enough insulin to help change the sugar in food into energy. AmeriHealth Caritas Louisiana wants to work with you to help you control your diabetes and live a healthy, active life.

The Diabetes program will help you learn about diabetes. It will help you understand what medicines you are taking. The program will also help explain what foods you should eat and the testing of sugar levels in your blood.

Cardiovascular programs - Heart disease and heart failure

Heart disease, also called coronary artery disease, is a long-term illness that affects the coronary arteries in the heart. With heart disease, cholesterol builds up on the walls of the arteries. The arteries become narrowed and blocked.

The heart disease program will help you learn about your condition. The program will explain why it is important to check your blood pressure and cholesterol and why you need to eat healthy and exercise.

Heart failure is a long-term illness that affects the ability of your heart to pump blood.

The heart failure program will help you learn about your condition and help you understand about the medicines you are taking. The program will help explain why it is important to weigh yourself and avoid foods that can make you retain fluids (get puffy feet, “hold water”).

Complex care management

AmeriHealth Caritas Louisiana has integrated care management programs for members who have special health care needs, behavioral health conditions, and chronic conditions such as asthma, diabetes, and high blood pressure. In this program, you will work with a Care Manager who will help you get the services and information you need to improve your health.

Services include helping you to:

  • Get a complete health evaluation with you and your caregiver.
  • Find information about your medical needs.
  • Get your medicines and medically necessary equipment and supplies.
  • Arrange for transportation.
  • Find specialists. 
  • Connect to community resources.

Support is available for your move from one care setting to another

Our Transition in Care program provides a safe transition from hospital to community. Interventions are developed while you are an inpatient. You will be contacted within 24 to 48 hours of notification of your discharge. A Care Manager will follow up with you post-discharge. An assessment is completed to ensure you understand your discharge instructions, and received medications and a post-discharge follow-up appointment. We will work with you to ensure a safe discharge and prevent a readmission.

If you experience/require frequent trips to the emergency room (ER) we are here to assist

If you received ER care, a Care Manager will follow up with you after your ER visit to offer assistance with discharge instructions, educate you on appropriate use of the ER versus an urgent care center, and assist with scheduling follow up appointments to keep you healthy.

Benefits of this program are as follows:

  • You have an assigned PCP and have an appointment for follow-up and maintenance care.
  • You are educated on how and where to seek appropriate level of care.
  • You are provided contact information for the Nurse Call Line, and participating Urgent Care Centers/Minute Clinics.
  • You are provided education on available transportation services.
  • You are connected to the Community Care Management Team, Care Coordination, Complex Care Management and Community Health Navigators.

Other information about your benefits

Learn more about AmeriHealth Caritas Louisiana by viewing the Roadmap to Health (PDF) and the Member Benefits Chart (PDF).