Manage your condition
Disease management is all about you. We’re here to help you learn more about your health, keeping you and your needs in mind at every step. Our disease management programs give you the opportunity to ask questions about your condition, get information about your benefits and connect you with local resources.
How it works
Our DM case managers are registered nurses. They’ll help you to better manage your condition or health issue, which may improve your quality of life.
When you join one of our DM programs, a DM case manager will:
- Help you create health goals and make a plan to reach them
- Coach you and support you through one-on-one phone calls
- Track your progress
- Give you information about local support and caregivers
- Answer questions about your condition and/or treatment plan (ways to help health issues)
- Send you materials to learn about your condition and overall health and wellness
- Coordinate your care with your health care providers, like helping you with:
- Making appointments
- Getting to health care provider visits
- Referring you to specialists in our health plan, if needed
- Getting any medical equipment you may need
What programs do we offer?
We offer health care and support services for members with any of these conditions:
Alzheimer’s disease is a brain disease. It’s also the most common form of dementia. Dementia is a general term used for a group of symptoms. Signs and symptoms of dementia affect a person’s memory, thinking, and reasoning skills.
For members with long-term care benefits, we can help you by making sure you’re getting follow-up care and taking your medications.
Learn more:Alzheimer’s Disease
Asthma is a long-term condition that makes it hard to get air into the lungs. Asthma may cause wheezing, tightness in the chest, shortness of breath and coughing.
We can give you an asthma action plan for you and your health care provider to complete. This will help monitor your condition, stay away from your triggers and manage your medication (meds).
Know Your Triggers
Asthma Action Plan
Bipolar disorder is a brain disorder that can cause unusual changes in mood, energy, activity level, and make it hard to carry out day-to-day tasks.
It can feel uneasy to learn you’re living with bipolar disorder, so we’re here to help. With proper treatment and support, you can enjoy a healthy, happy and productive life.
Learn more:Bipolar Disorder
When to Call a Doctor
COPD is a condition in which damage to the lungs has caused the airways to change shape and feel partly blocked. This makes it hard to breathe.
We can help you learn to breathe easier to possibly improve your quality of life. We’ll help you learn how to use inhalers, spacers, nebulizers and other devices, along with other skills for living with COPD.
COPD: Learning to Breathe Easier
Taking care of your heart is one of the best things you can do for your health. The heart pumps blood to the whole body. Having CHF means the heart can’t pump as hard as it should.
We can help you understand CHF better. That way, you and your health care provider(s) can work together to help you feel your best.
Learn more:Heart Failure
When to Call a Doctor
Your heart is only the size of a fist, but it’s one of the most important muscles in your body. Arteries throughout the body supply blood to your heart. When those arteries are blocked, and blood flow to the heart is reduced, it causes CAD.
We can help you with tips and tools, like making good food choices and following up with your doctor to keep your CAD in check.
Learn more:Coronary Artery Disease (CAD)
When to Call a Doctor
If you’re living with diabetes, you’re not alone. Diabetes happens when your body’s blood sugar (the amount of sugar in the blood) levels are usually higher than normal. It means there’s a problem making enough of a hormone called insulin, or your body isn’t using insulin like it should.
We can help you lower your risk of complications (problems or issues) and make your quality of life better.
Learn more:Type 1 Diabetes
Type 2 Diabetes
Taking Care of Your Feet
Healthy Eating Tips
Hypertension is also called high blood pressure. Blood pressure is the amount of force it take for your heart to pump blood through your body. When your blood pressure is high, it can lead to other health problems.
We can help you make short- and long-term goals that will help you manage your blood pressure.
Learn more:High Blood Pressure
What Increases Your Risk
Everyone feels blue or sad some of the time, but these feelings don’t last very long. When a person has major depressive disorder (MDD or clinical depression), these feelings don’t go away easily. They can get in the way of your everyday life.
Depression is common and a real illness. The important thing to know is that it can be treated. We’re here to help you find resources in your area or help you talk with your family or caregiver about MDD.
Symptoms of Depression
Kids and teens can also have major depressive disorder (MDD or clinical depression).
We can help kids and teens talk with their families and health care providers about MDD, get treatment and live a healthier life.
Learn more:Depression in Children and Teens
Schizophrenia is a behavioral health disorder that affects a person’s thoughts, feelings, emotions, decisions and actions. Some even have a hard time with focusing and memory loss. It can get in the way of daily life.
We’re here to help you learn how to manage schizophrenia with medication, treatment and support.
Schizophrenia: When Hospital Care is Needed
When to Call a Doctor
Substance use disorder is a disease that leads to the use of drugs, alcohol or other substances in a way that causes problems for your health or in your life.
We can help those with substance use disorder work together with their health care provider(s) to talk about treatment options (choices of ways to get better) and finding local community programs and resources.
Learn more:Substance Use Disorder
For Family and Friends
When to Call a Doctor
Any Simply Healthcare Plans (Simply) – Florida Healthy Kids member with any of the health conditions listed can participate in a DM program. Our DM case manager can talk with you about your health history, health goals and work with you to offer strategies and support so you can live well.
They can also offer educational materials and tools for weight management and tobacco cessation (how to stop using tobacco, like quitting smoking).
Members, you’ll get a letter welcoming you to a DM program, if you qualify. Or, call us toll free at 1-888-830-4300 (TTY 711) from 8:30 a.m. to 5:30 p.m. local time Monday through Friday.
When you call, we’ll:
- Set you up with a DM case manager to get started
- Ask you some questions about your or your child’s health
- Start working together to create your or your child’s plan
You can also email us at email@example.com.
Please be aware that emails sent over the internet are usually safe, but there is some risk third parties may access (or get) these emails without you knowing. By sending your information in an email, you acknowledge (or know, understand) third parties may access these emails without you knowing.
You can choose to opt-out (we’ll take you out of the program) of the program at any time. Please call us toll free at 1-888-830-4300 (TTY 711) from 8:30 a.m. to 5:30 p.m. local time Monday through Friday to opt-out. You may also call this number to leave a private message for your DM case manager 24 hours a day.
When you join a disease management program, you have certain rights and responsibilities. You have the right to:
- Get details about us, such as:
- Programs and services we offer
- Our staff and their qualifications (skills or education)
- Any contractual relationships (deals we have with other companies)
- Opt-out of DM services
- Know which DM case manager is handling your DM services and how to ask for a change
- Get support from us to make health care choices with your health care providers.
- Ask about all DM-related treatment options (choices of ways to get better) mentioned in clinical guidelines (even if a treatment is not part of your health plan), and talk about options with treating health care providers
- Have personal data and medical information kept private
- Know who has access to your information and how we make sure your information stays secure, private and confidential
- Receive polite, respectful treatment from our staff
- Get information that is clear and easy to understand
- File complaints to Simply – Florida Healthy Kids by calling 1-888-830-4300 (TTY 711) toll free from 8:30 a.m. to 5:30 p.m. local time Monday through Friday and:
- Get help on how to use the complaint process
- Know how much time Simply – Florida Healthy Kids has to respond to and resolve issues of quality and complaints
- Give us feedback about the disease management program
You also have a responsibility to:
- Follow the care plan that you and your DM case manager agree on
- Give us information needed to carry out our services
- Tell us and your health care providers if you choose to opt-out (leave the program)
Disease management does not market products or services from outside companies to our members. DM does not own or profit from outside companies on the goods and services we offer.
For a written version of your DM rights and responsibilities or information on this website, please print this page or call Member Services.
Useful phone numbers
In an emergency, call 911.
Leave a private message for your DM case manager 24 hours a day.
Toll free: 1-888-830-4300 (TTY 711)
Monday through Friday
8:30 a.m. to 5:30 p.m. local time
Call the 24-hour Nurse HelpLine
24-hours a day, 7 days a week
1-844-405-4298 (TTY 711)
Healthy Families is a six-month program for members ages 7-17. The goal of the program is to help families form healthy eating habits and become more active.
For kids who qualify, parents will get one-on-one coaching phone calls with us to:
- Create health goals just for your child that are clear and that they can meet.
- Make a plan to reach those goals.
- Talk about getting and staying active and healthy food choices.
- Help find resources to support a healthy life in your area.
- Find out if your health plan has extra benefits to help with living a healthier life.
Learn more and join
Give us a call at 1-844-421-5661 Monday through Friday 8:30 a.m.-5:30 p.m. local time to find out more about the program. We’ll ask you some questions about your child’s health to see if they qualify.