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. 

Special health programs

If you have a chronic condition, our special health programs can help. You don’t need a referral to participate. If you have one of the conditions listed below, you can join one of our special programs.

Blue Cross Complete also doesn’t require medical service referrals, but we 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 enroll in a special health program if you have:

  • Asthma
  • Chronic kidney disease
  • Chronic obstructive pulmonary disease
  • Diabetes
  • Heart disease
  • Hemophilia
  • Hepatitis C
  • High blood pressure
  • HIV
  • Sickle cell anemia

These programs can help you learn more about your condition so you can manage it. They may also help improve your quality of life. As part of the program, you’ll receive information in the mail. You can request a case manager to assist you with your health care needs.

A case manager is a nurse or social worker who will help you manage your care. A case manager will call you to find out how you're doing. They’ll send you information about your condition, coordinate care with your medical providers and help you with resources you may need to improve your health.

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

The Complex Care Management program can help you:

  • Understand and manage your chronic health conditions.
  • Identify your medical and non-medical needs.
  • Understand your medications.
  • Set goals to improve your health.
  • Find the right doctors and specialists to manage your care.
  • Connect to available resources in your community.

You can join a special program or Complex Care Management by:

  • Logging in to your member account at mibluecrosscomplete.com and clicking on Enroll in a Special Program.
  • Calling Customer Service at 1-800-228-8554, 24 hours a day, seven days a week. TTY users, call 1-888-987-5832.
  • Writing to Member Services:
    Member Services
    4000 Town Center, Suite 1300
    Southfield, MI 48075

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 of a special program or Complex Care Management, 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.

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 kidney disease1, or CKD, is permanent kidney damage or a decreased level of kidney function. If left untreated, CKD can lead to complete kidney failure. In most cases, CKD is caused by diabetes and high blood pressure. 33% of American adults are at risk for kidney disease2. Take this quiz  from the National Kidney Foundation to find out if you’re part of the 33%.

There are often no symptoms in the first phases of CKD. A urine test can detect early stage kidney disease. As the disease gets worse you may notice:

  • More frequent urination, especially at night
  • Painful or difficult urination
  • Puffiness around the eyes or swelling of hands and feet, especially in children

You’re at higher risk for CKD if you:

  • Have diabetes
  • Have high blood pressure
  • Have a family member with CKD
  • Are Black, Hispanic, Native American, Asian or a Pacific Islander
  • Are overweight

Testing for CKD includes testing your:

  • Blood pressure
  • Urine
  • Blood, called a GFR test

Learn more about CKD, including symptoms, why it’s important to get tested and what you can do to keep your kidneys healthy:

 

1. “Kidney Disease,” nkfm.org, December 13, 2023, https://nkfm.org/conditions/kidney-disease/#ckd

2. “Kidney Quiz,” kidney.org, December 13, 2023, https://www.kidney.org/kidney-quiz/?utm_source=organic&utm_medium=feild&utm_campaign=kidney-quiz_michigan_conversion

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. “About Hemophilia,” Centers for Disease and Control and Prevention, June 4, 2024, https://www.cdc.gov/hemophilia/about/index.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/.

High blood pressure1, or hypertension, is blood pressure that is higher than normal. Blood pressure is the pressure of blood pushing against the walls of your arteries. Your blood pressure changes throughout the day based on what you’re doing. High blood pressure means your blood pressure consistently measures above normal.

There are often no symptoms of high blood pressure. If left untreated, high blood pressure can cause heart attack, heart disease, stroke and brain problems and kidney disease.

You can prevent or manage high blood pressure by:

  • Getting at least 150 minutes of physical activity each week
  • Not smoking or quitting smoking
  • Eating a healthy diet, limiting sodium and alcohol
  • Keeping a healthy weight
  • Managing stress

 

1. “About High Blood Pressure,” cdc.gov, June 4, 2024, https://www.cdc.gov/high-blood-pressure/about/.

Human immunodeficiency virus1, or HIV, is a virus that attacks the body’s immune system. Without treatment, HIV can lead to AIDS. There currently is no cure for HIV. Once someone gets HIV, they have it for life. Proper medical care can help control the virus.

HIV is most commonly spread through sex or sharing needles with someone who has HIV. The only way to know your HIV status is to get tested.

You can prevent HIV by:

  • Using condoms the right way every time you have sex.
  • Never sharing needles, syringes or drug injection equipment.
  • Using pre-exposure prophylaxis, PrEP, or post-exposure prophylaxis, PEP.

If you’re living with HIV, resources and support are available. For more information, view our HIV Resources and Support PDF.

 

1. “About HIV,” cdc.gov, June 3, 2024, https://www.cdc.gov/hiv/about/index.html

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.

Need a ride?

Blue Cross Complete offers transportation at no cost to medical appointments, pharmacies, durable medical equipment suppliers and more. Our transportation provider, ModivCare (previously called LogisitiCare), can help you get there. Visit our Transportation page to learn more about your transportation benefit and schedule a ride online. To schedule by phone, call 1-800-803-4947 (TTY: 711). You can also get reimbursement for gas mileage if you drive yourself or are driven by a friend or family member.

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

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 under the age of 26. Persons with sickle cell, cystic fibrosis or certain hereditary blood coagulation disorders, commonly known as hemophilia, may also qualify regardless of age.
  • 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 includes 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

Freedom to Work

Michigan’s Freedom to Work program expands Medicaid eligibility to disabled adults with earned income. You may have to pay a monthly premium. Eligibility is determined by MDHHS. 

To be eligible for the Freedom to Work program, you must:

  • Be age 16 through 64 years old.
  • Meet non-financial and financial factors.
  • Be disabled according to the Social Security Administration disability standards.
  • Be employed on a regular basis.
  • Be below 250% of the federal poverty level.

To learn more, contact your local MDHHS office.

Override Health

Override Health is a chronic pain management program available to members at no cost. This virtual program helps you build a toolbox of mental and physical exercises to help manage your pain. When you enroll, you’re given a specialty care team that may include a pain medicine physician, pain-trained physical therapist, psychologist and certified pain coach.

To learn more or sign up, call the Override Support Line at 1-646-598-8338.

Override Health, a separate company, has a contract with Blue Cross Complete to provide pain management services to certain Blue Cross Complete members.