Special Health Care Programs

Care Coordination

AmeriHealth Caritas Delaware has special programs to help you get and stay healthy. You do not need a referral for any of these programs. If you have one of the conditions listed below, you can join one of our special programs.

What conditions do you have programs for?

What can these programs do for me?

These programs can help you learn more about your condition. They can help you manage your condition. They may help improve your quality of life.

A Care Coordinator will manage your care. They will send you information about your condition. A Care Coordinator will also call you to find out how you are doing. They will help you to get program services.

How can I join one of these programs?

You can join any of these programs by any one of these ways:

  1. Call care coordination at 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769) Monday-Friday, 8am – 5pm.

If you need to contact outside of normal business hours, call AmeriHealth Caritas Delaware Member Services, 24 hours a day, seven days a week, at:

  • Diamond State Health Plan: 1-844-211-0966 (TTY 1-855-349-6281).
  • Diamond State Health Plan-Plus: 1-855-777-6617 (TTY 1-855-362-5769).
  1. Your PCP (primary care practitioner), specialist, or other health care provider may also talk to you about becoming a part of the program. He or she can call us to have you join.
  2. We may see from your health history that you might benefit from the program. We will send you information in the mail about what to do to enroll in the program.

How to leave a program

You can tell us on the phone if you do no longer want to be a part of a program.

  • Call: 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769)

Leaving a program will not change your benefits. It will also not change the way AmeriHealth Caritas Delaware or the Delaware Department of Health and Social Services treats you.

Questions?

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 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769).

Complex care management

AmeriHealth Caritas Delaware 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 Coordinator who will help you get the services and information you need to improve your health. Call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769) today to join the complex care management program.

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.

Pregnancy Program - Bright Start®

Bright Start is a special program for our pregnant members.

When you join Bright Start, a care coordinator will call you and work with you to help you receive and use program services. If your pregnancy is high-risk, a team of nurses and care connectors will check in with you often to help you stay connected to care during your pregnancy.

Call 1-833-669-7672 (TTY 1-855-349-6281) today to join the Bright Start program.

What can the Bright Start program do for me?

  • Get help signing up for childbirth and other health information classes.
  • Get help choosing a provider who is right for you.
  • Get information on prenatal vitamins and eating right during your pregnancy.
  • Work with your provider and dentist to help make sure you get care you need. Having healthy teeth and gums is very important during pregnancy.
  • Get information and resources to help you have a safe pregnancy and a healthy baby.

Join Bright Start today

All pregnant members are eligible for the Bright Start program. If you are pregnant and want to join Bright Start, please call 1-833-669-7672 (TTY 1-855-349-6281).

Questions?

If you were a part of but no longer want to be in Bright Start, call 1-833-669-7672 (TTY 1-855-349-6281). Leaving the program will not change your benefits. It will also not change the way AmeriHealth Caritas Delaware or the Delaware Department of Health and Social Services treats you.

Heart Failure Program

AmeriHealth Caritas Delaware members with heart failure can join a special program to help them manage their condition.

Call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769) today to join the heart failure program.

What can the heart failure program do for me?

With treatment, you can help control heart failure. This care management program can help you learn:

  • More about heart failure.
  • More about the medicines you take.
  • Why it is important to know your weight.
  • Why you should avoid salty foods that can cause you to hold fluids (get puffy feet, "hold water").

What is heart failure?1

Heart failure happens because your heart muscle is weak and there is too much fluid inside of it. Without proper treatment, heart failure can:

  • Cause your legs, feet and ankles to swell.
  • Cause confusion or impaired thinking.
  • Cause loss of appetite or nausea
  • Cause coughing and wheezing that won't stop, making it difficult for you to breathe.
  • Make you heart work harder.
  • Make your energy level low.
  • Be very dangerous to your life.

Join the heart failure program today

Members with a heart failure diagnosis are eligible for this program. To join the heart failure program, please call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769).

Questions?

If you were a part of but no longer want to be in the heart failure program, call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769). Leaving the program will not change your benefits. It will also not change the way AmeriHealth Caritas Delaware or the Delaware Department of Health and Social Services treats you.

1. “Warning Signs of Heart Failure,” American Heart Association, May 31, 2017, https://www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure.

Chronic Obstructive Pulmonary Disease (COPD) Program

AmeriHealth Caritas Delaware members with COPD can join a special program to help them manage their condition.

Call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769) today to join the COPD program.

What can the COPD program do for me?

The COPD Program can help you:

  • Understand what COPD is.
  • Make a self-management plan.
  • Understand and manage your daily medications.
  • Learn the early warning signs of a COPD flare-up.

What is COPD?1

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. This makes it hard to breathe.

COPD develops slowly, so it may take years before you see any of these symptoms:

  • 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 Delaware Quitline at 1-866-409-1858. Talk to your doctor about medicines that can help you quit.

Join the COPD program today

Members with a lung disease diagnosis are eligible for this program. To join the COPD program, please call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769).

Questions?

If you were a part of but no longer want to be in the COPD program, call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769). Leaving the program will not change your benefits. It will also not change the way AmeriHealth Caritas Delaware or the Delaware Department of Health and Social Services treats you.

1. “COPD,” National Heart, Lung, and Blood Institute, https://www.nhlbi.nih.gov/health-topics/copd.

Diabetes Program

AmeriHealth Caritas Delaware members with diabetes can join a special program to help them manage their condition.

Call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769) today to join the diabetes program.

What can the diabetes program do for me?

The diabetes program can help you:

  • Understand the medications you are taking.
  • Know the importance of the foods you eat.
  • Know why it is so important for you to test your blood sugar as often as your provider asks you to.
  • Understand why exercise and weight control are so important.

What is diabetes?1

Diabetes is a disease that affects how your body breaks down sugar. It causes your body to have too much sugar in the blood. It could also be that you do not have enough insulin. Insulin helps your body break down the sugar in the food you eat to give you energy.

If you do not have control of your diabetes, it can:

  • Cause you to go blind, get kidney disease, and have foot problems.
  • Make it easier to get infections and/or wounds that will not heal.
  • Put you at a higher risk of getting heart disease or having a stroke.
  • Cause you to have nerve damage.
  • Make you feel tired, thirsty and have to go to the bathroom much more than usual.

Join the diabetes program today

This program is open to members who have been diagnosed with diabetes. Members with uncontrolled diabetes and an A1C result of > (higher than) 6 are the focus of our efforts. To join the diabetes program, please call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769).

Questions?

If you were a part of but no longer want to be in the diabetes program, call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769). Leaving the program will not change your benefits. It will also not change the way AmeriHealth Caritas Delaware or the Delaware Department of Health and Social Services treats you.

1. “Diabetes,” familydoctor.org, September 20, 2020, https://familydoctor.org/condition/diabetes/.

Asthma Program

AmeriHealth Caritas Delaware members with asthma can join a special program to help them manage their condition.

Call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769) today to join the asthma program.

What can the asthma program do for me?

The asthma program can help you:

  • Understand what triggers your asthma.
  • Make an asthma action plan.
  • Understand your daily and rescue medications.
  • Learn the early warning signs of an asthma attack.

[INSERT INFORMATION ABOUT THE PROGRAM]

What is asthma?1

Asthma is a long-term illness that makes the airways to your lungs narrow, swollen, or blocked. It is important to do everything you can to keep your asthma under control.

Uncontrolled asthma:

  • Makes it hard for you to breathe.
  • Keeps you from playing sports or doing physical activities.
  • Can cause you to miss work or school.

You can control asthma if you:

  • Know your triggers and how to avoid them.
  • Take your daily medicine as directed by your provider.
  • Use your rescue inhaler as directed by your provider.

Join the asthma program today

The asthma program is designed for individuals who have uncontrolled asthma, are on several medicines, or have had many asthma emergency visits. To join the asthma program, please call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769).

Questions?

If you were a part of but no longer want to be in the asthma program, call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769). Leaving the program will not change your benefits. It will also not change the way AmeriHealth Caritas Delaware or Delaware Department of Health and Social Services treats you.

1. “Asthma,” National Heart, Lung, and Blood Institute, September 18, 2014, https://www.nhlbi.nih.gov/health-topics/asthma.

HIV/AIDS Program - Pathways

AmeriHealth Caritas Delaware members with HIV/AIDS can join Pathways, a special program to help them manage their condition.

Call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769) today to join the Pathways program.

What can the Pathways program do for me?

Once you enroll in the program, you will be assigned a care coordinator. Your Pathways care coordinator can:

  • Help you and your PCP/specialist set up your health care.
  • Help you to find providers who can meet your needs.
  • Work with the local AIDS service organizations. They can help you make sure you get medical services you need.
  • Be your contact at [PLAN].

The Pathways program offers help to any member who tells us about their HIV status. Information about your medical condition is kept confidential. If you choose not to tell us about the status of your HIV, you can still get general care to help you manage your condition through our care management department.

Join the Pathways today

This program is open to members who have been diagnosed with HIV/AIDS. To join Pathways, please call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769).

Questions?

If you were a part of but no longer want to be in the Pathways program, call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769). Leaving the program will not change your benefits. It will also not change the way AmeriHealth Caritas Delaware or the Delaware Department of Health and Social Services treats you.

Sickle Cell Anemia Program

AmeriHealth Caritas Delaware members with sickle cell anemia can join a special program to help them manage their condition.

Call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769) today to join the sickle cell anemia program.

What can the sickle cell anemia program do for me?

The sickle cell anemia program can help you learn about:

  • Sickle cell anemia, your medicines, and lifestyle.
  • Getting care.
  • How to lessen pain.
  • The danger of having a stroke.
  • How important it is to get your shots (immunizations).

What is sickle cell anemia?1

Sickle cell anemia is a genetic disease. This means people with sickle cell anemia are born with it. When you have sickle cell anemia, some of the blood cells in your body are not a normal shape. Because of the shape, these cells can block blood flow. This can cause pain. It may also cause infections and other complications.

Join the sickle cell anemia program today

To be eligible for this program, members must have been diagnosed with sickle cell anemia. To join the sickle cell anemia program, please call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769).

Questions?

If you were a part of but no longer want to be in the sickle cell anemia program, call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769). Leaving the program will not change your benefits. It will also not change the way AmeriHealth Caritas Delaware or the Delaware Department of Health and Social Services treats you.

1. “Sickle Cell Disease,” MedlinePlus, https://medlineplus.gov/sicklecelldisease.html.

Behavioral Health Program

AmeriHealth Caritas Delaware members experiencing mental illness and substance use disorders can work with care coordinators to help them manage their condition.

Call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769) to join the Behavioral Health program.

What can the Behavioral Health program do for me?

The Behavioral Health Program can help you:

  • Understand and work on your Mental Illness(es).
  • Work through drug use.
  • Work through alcohol use

If you think you need these services, talk to your primary care provider (PCP). This is the best place to start. Tell your PCP how you feel. Your care coordinator will work with your PCP and other providers/programs to manage these services.

What are Behavioral Health services?

Your benefits and services depend on your age and the Medicaid plan you are in.

Addiction services: These services help you stop using alcohol or drugs.

Behavioral health outpatient services: These are planned, regularly scheduled visits with a doctor, counselor or therapist. You will talk about your behavioral health issues.

Inpatient hospitalization for mental health and substance use disorders: This is the most serious care you can get. This is care you get in a hospital. You may be hospitalized if:

  • You are at risk of harming yourself or others.
  • You experience a behavioral health crisis.
  • Your medicines need to be watched closely.
  • Other care didn’t help your problem.

Psychiatric residential treatment facility (PRTF): This service is for AmeriHealth Caritas Delaware members ages 18-21 years old. It provides long-term, 24-hour care in a group living facility.

Autism services

You can get services if you have autism spectrum disorder, such as:

  • Applied behavior analysis.
  • Family counseling.
  • Parent training.
  • Physical therapy.
  • Speech therapy.
  • Occupational therapy

Join the Behavioral Health program today

These services need to be medically necessary to be covered. To join the Behavioral Health, please call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769).

Questions?

If you were a part of but no longer want to be in the Behavioral Health program, call 1-844-623-7090 (Diamond State Health Plan [DSHP] TTY 1-855-349-6281 or DSHP-Plus TTY 1-855-362-5769). Leaving the program will not change your benefits. It will also not change the way AmeriHealth Caritas Delaware or the Delaware Department of Health and Social Services treats you.

Note: AmeriHealth Caritas Delaware provides coverage for the first 30 hours of outpatient behavioral health treatment. Following the utilization of 30 hours of coverage, DSCYF assumes coverage. DSCYF provides services to members under the age of 18. AmeriHealth Caritas Delaware will continue to provide eligible members with care coordination and resource support if they are under the age of 18.

Members