CarelonHealth - formerly known as CareMore
As an independent insurance agent with Blake Insurance Group, I’ve seen my fair share of Medicare Advantage plans come and go. But let me tell you, Carelon Health, formerly known as CareMore, has caught my attention lately. They’re shaking things up in the senior care world, and I think it’s worth taking a closer look.
I know what you’re thinking – another Medicare plan, right? But hear me out. Carelon Health isn’t just offering your run-of-the-mill coverage. They’re taking a whole new approach to keeping seniors healthy and happy. From what I’ve seen, they’re all about providing comprehensive care beyond just treating illnesses.
In my years of helping folks navigate the maze of Medicare options, I’ve learned that it’s not just about finding the lowest premium. It’s about finding a plan that meets your needs and helps you stay healthy. And that’s where Carelon Health seems to be making a real difference.
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CarelonHealth Medicare Advantage Plans
**Coordination with Medicare Advantage Plans**
CarelonHealth is a provider network that partners with specific Medicare Advantage plans. When patients enroll in a Medicare Advantage plan that includes CarelonHealth, they gain access to the wide range of healthcare services Carelon offers. These services are often designed to address the unique needs of Medicare beneficiaries, including seniors and those with chronic conditions.
**Comprehensive Care Management**
One of CarelonHealth’s key strengths is the coordination of care. For Medicare Advantage members, this means working with primary care doctors, specialists, and care managers to ensure every aspect of a patient’s health is monitored and treated effectively. The focus is prevention, early intervention, and managing chronic diseases to avoid costly hospital visits.
**Medicare Advantage Coverage**
Medicare Advantage plans typically cover everything that Original Medicare (Part A and Part B) covers and often offer additional benefits. CarelonHealth works within these frameworks to provide additional services like dental, vision, hearing, and wellness programs. Their services help maximize the coverage provided by the plan.
**Primary Care and Specialist Access**
As a CarelonHealth member through a Medicare Advantage plan, you’ll have access to primary care doctors who coordinate with specialists as needed. For patients with complex health issues or chronic conditions, this ensures that all aspects of care are managed under one umbrella, simplifying healthcare management.
**Chronic Disease Management**
CarelonHealth is known for its proactive approach to managing chronic diseases such as diabetes, heart disease, and COPD. For Medicare Advantage members, this means regular monitoring, personalized care plans, and support to maintain or improve health outcomes over time.
**Behavioral Health and Wellness Programs**
Many Medicare Advantage plans cover behavioral health services, and CarelonHealth integrates these into their overall care strategy. Patients can receive counseling, mental health treatment, and substance abuse support, which complements their physical health care. Additionally, the package often includes wellness programs designed to promote healthy lifestyles.
**Affordable Healthcare**
Medicare Advantage plans typically have lower out-of-pocket costs than Original Medicare, and CarelonHealth works within the structure of these plans to keep healthcare affordable. Focusing on preventive care and chronic condition management, CarelonHealth helps patients avoid expensive emergency visits and hospitalizations, making healthcare costs more predictable.
**Telehealth Services**
Many Medicare Advantage plans now include telehealth services, and CarelonHealth has embraced this option to provide patients with remote access to care. This is especially helpful for routine check-ups, follow-ups, or managing chronic conditions, making healthcare more convenient for patients.
**How to Access CarelonHealth Services**
To access CarelonHealth services, you must be enrolled in a Medicare Advantage plan that includes CarelonHealth in its network. If you’re unsure which plans include CarelonHealth, an independent insurance agent, like Blake Insurance Group, can help you identify and enroll in the plan that best suits your needs.
**Holistic Approach to Healthcare**
What sets CarelonHealth apart is its holistic approach to care, which combines medical, behavioral, and social health services. With Medicare Advantage, this comprehensive care helps ensure that patients receive the proper care at the right time, reducing gaps in treatment and improving overall well-being.
Carelon Health accessibility
Carelon Health emphasizes accessibility in various ways to ensure patients can access care and manage their health easily. Here are some key points about Carelon Health’s accessibility features:
**Telehealth Services**: Carelon Health offers telehealth appointments, which allow patients to connect with doctors or nurses via the Internet or phone. This is particularly beneficial for those who live far from care services, have time or transportation limitations, or require regular monitoring.
**Home Visits**: Carelon Health provides home visits, which can relieve anxiety and ensure that patients can receive care in their homes.
**Extended Day Supply and Home Delivery**: Patients can get their prescriptions in extended day supplies (90- or 100-day) and have them delivered to their homes, reducing the need for frequent pharmacy trips and potentially lowering copays.
**24-Hour Care Line**: Carelon Health offers a 24-hour care line, providing patients with continuous support and access to care anytime.
**Care Centers**: Carelon Health operates care centers in neighborhoods nationwide, offering a wide range of services and treatment options coordinated by primary care doctors or nurse practitioners. These centers focus on whole-health support programs, including fitness classes, memory care, behavioral health, wound care, and smoking cessation.
**Healthy Start Assessment**: Carelon Health encourages patients to take a comprehensive Healthy Start assessment, which includes medication reviews, balance, and physical mobility evaluations, on-site lab testing, preventive screening, and referrals to specialty care and behavioral health as needed.
**Accessibility Features**: Carelon Health’s websites and digital tools are designed to be accessible to all users, including individuals with disabilities. They follow the Web Content Accessibility Guidelines (WCAG) version 2.1 Level AA and Section 508 of the U.S. Rehabilitation Act to ensure that their digital platforms are usable by everyone.
Customer Service and Reviews of Carelon Health
Carelon Health, formerly known as CareMore, has mixed reviews from patients, reflecting both positive and negative experiences with their customer service and healthcare services.
Positive Reviews
**Prompt Service**: Many patients appreciate the prompt and courteous service they receive at Carelon Health Care Centers. For example, Patrick C. from Las Vegas mentions that he has never had a problem getting an appointment and that there are no long waits to see the doctor.
**Comprehensive Care**: Patients like Mary, Steven, and Katherine have reported positive experiences with Carelon Health’s comprehensive care model, which includes preventive medicine, home visits, and responsive care teams.
**Personalized Care**: Patients often praise the personalized care they receive, feeling treated like individuals rather than numbers. For instance, Jackie and Ron mention that their nurse practitioners made a significant difference in their lives and provided continuous support.
Negative Reviews
**Insurance Issues**: Some patients have encountered insurance coverage and billing issues. For example, Krista A. from Nellis Air Force Base mentions that Carelon Health only accepts Blue Cross Insurance and Medicaid and that they had no written policies for these new rules.
**Communication Problems**: Judi C. from Los Gatos reports experiencing problems with prescription refills and unreturned calls, indicating issues with communication and coordination.
**Long Wait Times**: Some patients have reported long wait times, such as the 31-minute wait without an answer mentioned by a reviewer at the Downey location.
Company Response
Carelon Health has shown a willingness to address patient concerns. For example, they have responded to negative reviews on Yelp, inviting patients to share more details about their experiences so that they can improve their services.
Overall
While Carelon Health has received positive feedback for its comprehensive and personalized care, it also faces challenges related to insurance coverage, communication, and wait times. The company’s proactive approach to addressing patient concerns suggests a commitment to improving its services.
Contact Carelon Health's Customer Service
Phone Number:
- General Support: 844-998-3753 (available 8 am to 5 pm local time)
- Advanced Primary Care After Hours: Directed to the Carelon Health Nurse Help Line
- Pharmacy Services: 833-419-0530
- Post-Acute Care: 844-411-9622
- Claims and Billing: 833-241-0428
Email:
- General Inquiries: Use the contact form on their website
- Pharmacy Services: [email protected]
- Post-Acute Care: Email the provider network team
Address:
- Carelon Health Care Centers: 10000 Lakewood Blvd, Downey, CA 90240
- CarelonRx: 450 Headquarters Plaza, 7th Floor East Tower, Morristown, NJ 07960
Hours:
- General Support: 8 am to 5 pm local time
- Care Centers: Typically 8:00 AM - 5:00 PM, may vary by location
- Post-Acute Care: 8:00 am – 5:00 pm CST
Customer Review
"Carelon Health has been a life-saver for managing my chronic conditions. Their team is always responsive and goes the extra mile to make sure I’m well taken care of. I especially appreciate the coordination between my primary care doctor and specialists." - 5/5 Stars
FAQs about CarelonHealth (CareMore)
What is CarelonHealth (formerly CareMore)?
CarelonHealth, previously known as CareMore, is a healthcare provider that focuses on providing comprehensive and coordinated care, especially for Medicare beneficiaries. They offer services such as primary care, chronic condition management, and wellness programs with a focus on improving patient outcomes.
What services does CarelonHealth offer?
CarelonHealth offers a wide range of services, including primary care, specialty care, chronic disease management, behavioral health services, and wellness programs. Their care model is patient-centered, aiming to offer holistic healthcare tailored to the needs of each individual.
What type of insurance plans does CarelonHealth accept?
CarelonHealth primarily works with Medicare Advantage plans. If you are enrolled in a Medicare Advantage plan, you may be eligible for their services. However, it’s important to check with your insurance provider or your agent to confirm network availability and coverage.
How is CarelonHealth different from other healthcare providers?
CarelonHealth focuses on a proactive, patient-centered approach. They offer personalized care management for individuals with chronic conditions and emphasize wellness and preventive care. Their coordinated team approach involves primary care doctors, specialists, and care managers working together to provide comprehensive care.
Does CarelonHealth offer telehealth services?
Yes, CarelonHealth provides telehealth services to offer patients more convenient access to healthcare. This allows patients to consult with their doctors or specialists without needing to travel to a clinic, making it especially useful for routine follow-ups and non-urgent care.
Can CarelonHealth help manage chronic conditions?
Yes, one of CarelonHealth’s key strengths is its chronic condition management. They provide care for conditions such as diabetes, heart disease, and chronic obstructive pulmonary disease (COPD) by offering personalized care plans, regular follow-ups, and comprehensive support.
Is CarelonHealth only for seniors?
While CarelonHealth specializes in Medicare Advantage plans, which are typically for individuals 65 and older, they may also offer services for younger individuals with certain disabilities who qualify for Medicare.
Does CarelonHealth provide behavioral health services?
Yes, CarelonHealth integrates behavioral health into their overall healthcare approach. They offer mental health services, including support for depression, anxiety, and substance abuse, ensuring that patients receive comprehensive care for both their physical and mental well-being.
How can I sign up for CarelonHealth services?
If you're interested in CarelonHealth services, the first step is to ensure you have an eligible insurance plan, such as a Medicare Advantage plan. Contact your insurance provider or speak with an independent insurance agent like Blake Insurance Group to explore your options and see if CarelonHealth is available in your area.
What wellness programs does CarelonHealth offer?
CarelonHealth offers a variety of wellness programs, including fitness and nutrition guidance, preventive care services, and education programs to help patients maintain healthier lifestyles. These programs aim to prevent illness and promote long-term well-being.
Is transportation assistance available through CarelonHealth?
Yes, CarelonHealth may offer transportation assistance for eligible members who have difficulty traveling to and from medical appointments. This service is designed to ensure patients have easy access to the care they need.
Where is CarelonHealth available?
CarelonHealth services are available in select locations. To find out if they’re available in your area, check with your Medicare Advantage plan provider or consult an independent insurance agent like Blake Insurance Group.
Blake Insurance Group
Phone: (888) 387-3687
Email: [email protected]
Hours: Mon-Fri 9:00 am to 5:00 pm
Sat-Sun: Closed
Blake Nwosu
Owner & Principal Agent