Special Programs

Blue Cross Complete of Michigan offers special programs that foster improved health and well-being. These programs benefit our members and their families. You can learn more about them below. 

Disease management and complex care specialty programs

If you have a chronic condition, our disease management and complex care programs can help. You don’t need a referral for any of these special programs.

Blue Cross Complete also doesn’t require medical service referrals. We do recommend you talk with your primary care provider to coordinate care. We can help you find a doctor.

As a member of our plan, you may be enrolled in our disease management program if you have:

  • Asthma
  • Chronic obstructive pulmonary disease
  • Diabetes
  • Heart disease
  • Hemophilia
  • Hepatitis C
  • Sickle cell anemia

As a part of this program, you’ll receive information in the mail. You can request a case manager to assist you in managing your health care needs.

If you have a serious health condition or multiple medical issues, you may be enrolled in our Complex Care Management program. It provides you with more care to better manage your needs.

Asthma1 is a long-term illness that makes the airways to your lungs narrow, swollen or blocked. It’s 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 doctor
  • Use your rescue inhaler as directed by your doctor

 

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

Chronic obstructive pulmonary disease1, or 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’s 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, call 1-800-QUIT-NOW (784-8669). Talk to your doctor about medicines that can help you quit.

 

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

Diabetes1 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 don’t 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 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
  

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

Heart failure1 happens because your heart muscle is weak and there’s 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 your heart work harder
  • Make your energy level low
  • Be very dangerous to your life
   

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.

Hemophilia1 is an uncommon disease. It’s genetic. That means people with hemophilia are born with it. When you have hemophilia, your body can’t clot your blood. This can make it hard for you to stop bleeding.

   

1. “What is Hemophilia?,” Centers for Disease and Control and Prevention, July 17, 2020, https://www.cdc.gov/ncbddd/hemophilia/facts.html.

Hepatitis C1 is a liver infection caused by the hepatitis C virus. It’s spread through contact with blood from an infected person. People with hepatitis C often don’t feel sick and many don’t know how they were exposed. When symptoms do appear, they’re often a sign of advanced liver disease. Chronic hepatitis C can result in serious, even life-threatening, health problems such as cirrhosis and liver cancer.

Learn more about hepatitis C, including how it’s spread, symptoms and why it’s important to get tested on this Hepatitis C Fact Sheet (PDF).

  

1. “Viral Hepatitis,” Centers for Disease Control and Preventionhttps://www.cdc.gov/hepatitis/.

Sickle cell anemia1 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.

   

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

Questions?

If you have questions about the programs shown here, talk to your doctor or specialist, or:

Call Customer Service
1-800-228-8554
TTY: 1-888-987-5832
24 hours a day, seven days a week

Write to
Member Services
4000 Town Center, Suite 1300
Southfield, MI 48075

You can join a special program by:

Your primary care provider, specialist or other health care provider may also talk to you about becoming part of a program. They can call us to have you join.

We may see from your health history that you might benefit from a program. We’ll send you information in the mail about how to enroll in the program.

To opt out, call 1-888-228-8554, 24 hours a day, seven days a week. TTY users call 1-888-987-5832. It won’t change your benefits. It won't change the way we or the Michigan Department of Health and Human Services treats you.

Children's Special Health Care Services

The state of Michigan's Children's Special Health Care Services provides extra support for children and some adults who have special health care needs. This program is in addition to the medical care your child gets from us.

CSHCS is part of Title V of the Federal Social Security Act. CSHCS helps those with chronic health problems by offering:

  • Coverage and referrals for specialty services.
  • Programs to support you in your role as the primary caretaker of your child.
  • Programs to help you care for your child at home while maintaining normal routines.
  • Programs which demonstrate awareness of cultural differences.
  • Programs to pull together the services of many different providers who work within different agencies.

Eligibility for CSHCS

Several factors decide whether a person is eligible for CSHCS.

  • Residency: You must be a Michigan resident.
  • Citizenship: You must be a U.S. citizen, documented non-citizen admitted for permanent residence or a non-citizen legally admitted migrant farm worker.
  • Age: Kids must have a qualifying medical condition and be 20 years old or under. Persons 21 and older with cystic fibrosis or certain hereditary blood coagulation disorders, commonly known as hemophilia may also qualify.
  • Qualifying medical condition: You must have a qualifying medical condition. More than 2,700 diagnoses are potentially eligible.

Finding a CSHCS doctor

If your child is enrolled in CSHCS, you may want to find a doctor who treats kids in this program. Here's how to search online:

  1. Go to the online provider search.
  2. Select Advanced Search.
  3. Under Location, choose your search area.
  4. Check Children Special Health Care Services.
  5. Click Submit.

Additional CSHCS resources

Family Center for Children and Youth with Special Health Care Needs – They provide a parent support network and training programs. It also offers financial help for programs about special needs. For more information, visit michigan.gov.

County health departments – They can also direct you to local resources. This inclcudes parent support groups, adult transition help, child care, vaccines and more.

Children's Special Needs Fund – The fund helps families get items not covered by Medicaid or CSHCS. These items promote the health, mobility and development of your child. They include wheelchair ramps, van lifts and mobility equipment. For information, visit michigan.gov/csnfund.

Questions?

If you have questions about CSHCS, need help finding a doctor, or need help from a specially trained nurse, call:

 

1-800-228-8554
TTY: 1-888-987-5832
24 hours a day, seven days a week

Understanding your MIChild benefits

MIChild is a health care program from the Michigan Department of Health and Human Services. It's for uninsured and underinsured kids under the age of 19. These kids are in need of medical, dental, vision, hearing and prescription coverage. There are no copays, coinsurance or deductibles. You pay $10 a month for all of your children who qualify. This applies even if you have more than one child. You can also choose to receive your care from us.

The MIChild program covers the following for kids under 19 years old:

  • Medical, dental, vision and hearing care
  • Emergency room and urgent care
  • Preventive immunizations
  • Diagnostic tests
  • Inpatient hospital care
  • Maternity care
  • Outpatient physical, occupational and speech therapy
  • Prescription drugs

Questions?

If you have questions about MIChild, call:

 

Customer Service
1-800-228-8554
TTY: 1-888-987-5832
24 hours a day, seven days a week