Case Management

Blue Cross and Blue Shield of Nebraska’s case managers are registered nurses able to assist member with cancer treatment, transplants, children with special needs, traumatic injuries and many other complex conditions. Our case managers do not replace the care members receive directly from their health care providers; they serve as their personal advocate in making informed decisions about their health care.


  • Provide information to help members understand their health care benefits
  • Identify and refer services and resources to meet members’ needs
  • Coordinate care plans with members, health care providers and any other relevant caregivers (including family members)
  • Encourage involvement in member’s treatment program and empower them to manage their condition
  • Consistently communicate with members to assure their needs are being met

To learn more about the case management program and mobile app or to request a demo, call 844-201-1546 or download the brochure. (pdf) updated 11/07/2017

HEALTH INSURANCE TERMS


COINSURANCE

The percentage of the bill you pay after your deductible has been met.

COPAY

A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 

DEDUCTIBLE

The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.

SUBSTANCE ABUSE DISORDER SERVICES

Includes behavioral health treatment, counseling, and psychotherapy


in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)

out-of-pocket

Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.

penalty

If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.

premium

The amount you pay to your health insurance company each month. 


Preventive services

Health care services that focus on the prevention of disease and health maintenance.

rehab SERVICES

Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).

specialist

A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.