Health and Care Coordination Services

When you have PrimeTime Health Plan, you have an experienced health team working for you.

Our Disease Management and Case Management programs will help you get the care you need, and our team of nurses and social workers are here for you when you need them. With PrimeTime Health Plan, you get the Medicare Advantage Plan benefits you deserve, one big reason why 90% of PrimeTime members stay PrimeTime members.

Your locally owned Medicare Advantage alternative is ready to help when you need care, and we also offer wellness plans to help keep you healthy. What’s Care Coordination? We’ve streamlined our health and wellness program into a system that’s a behind-the-scenes integration of healthcare available to you at no additional cost.

We are your advocates for care, information and community resources. Our programs are facilitated by our Care Coordination team of local physicians, nurses, dietitians, pharmacists and other clinical staff that can help you tackle potential and ongoing health and wellness issues.

Our members can count on us to help alleviate the costs of their healthcare procedures. But, we are much more than a Medicare Advantage Plan company. Not only do we help offset healthcare costs, we coordinate health and wellness experts with valuable resources to prevent health concerns arising in the first place. Of course, sometimes health issues are inevitable, which is why we have programs and staff in place to help manage those issues, too.

We provide the following services at no cost to you:

• Assistance with referrals and out-of-network specialists
• Help to transition your care to panel providers
• Care coordination to help you get the most from your benefits
• A registered nurse line available 24 hours a day/7 days a week at 330-363-7600 or toll-free at 1-855-409-6448
• Reliable educational materials
• Tools and resources to help you manage your health condition
• An experienced staff who will work with your doctors
• Referrals to agencies and services within your community

As a member, you can enjoy the Silver&Fit Healthy Aging and Fitness program at no additional cost beyond your monthly premium. Or for an additional buy-up price, you can join a Premium location. The Silver&Fit health and wellness program gives you the digital tools and personalized support you need to enjoy a better life balance. Start your healthy aging journey with a no-cost fitness center/YMCA membership at a participating location, one Home Fitness Kit per benefit year, digital workout videos on the Silver&Fit website or mobile app, Healthy Aging Coaching, rewards for tracking your fitness activity, and other member resources. Learn more about Silver&Fit program>>

How does the program work?

PrimeTime Health Plan’s board certified mental health registered nurse can offer telephonic support, health coaching, and provide education by phone or mail.

• Do you need extra support for depression, anxiety, substance abuse, bipolar disorder, or schizophrenia?
  • We can assist you in finding local resources.
• Are you interested in learning additional coping skills?
  • We can provide education and support to help you better manage your mental health.
• Do you have difficulty understanding your medications?
  • You will have exclusive access to education materials to help you understand all aspects of your mental health.

How does the program work?

• Are you newly diagnosed with heart failure?
  • An easy to use weight scale will be sent directly to your home with set up instructions.This scale collects your weight and sends it to your assigned registered nurse health coach to monitor signs of complications due to heart failure.
• Are you struggling to get your heart failure under control?
  • With participation in our program, your weights and symptoms are monitored and trends can be identified. The data can be shared with your physicians as needed, or on your scheduled appointment days.
• Are you having difficulty understanding your heart failure condition?
  • Throughout the tele-monitoring program, you will have exclusive access to educational materials to help you understand all aspects of your condition.

How does the program work?

• Have you been diagnosed with COPD?
  • An easy-to-use pulse oximeter and commander unit will be sent directly to your home with set up instructions. This commander unit will collect your Oxygen Saturation values and symptoms and it will send the information to your assigned registered nurse to monitor signs of complications from COPD.
• Are you struggling to get your COPD under control?
  • With participation in the program, your results are monitored and specific trends can be identified. The data can be shared with your physicians as needed on days when you have appointments.
• Are you having difficulty understanding your COPD condition?
  • Throughout the tele-monitoring program, you will have exclusive access to educational materials to help you understand all aspects of your condition.

How does the program work?

PrimeTime Health Plan’s Disease Management Health Coach Registered Nurse can offer telephonic support, health coaching, and provide educational resources.

• Do you have High Blood Pressure, High Cholesterol or Atrial Fibrillation? 
  • We can assist with individualized health coaching to address these stroke risk factors.
• Do you know the signs and symptoms of a stroke? ‍
  • You will learn how to spot a stroke and what to do if any symptoms are present.
• Have you had a stroke?
  • We can provide education and resources to cope with recovering from a stroke.

How does the program work?

• Are you at risk for becoming a diabetic?
  • PrimeTime Health Plan Pre-Diabetes Education will provide monthly material on how to help lower your risk of becoming diabetic.
  • Educational materials sent to your home will incorporate tips on healthy eating and exercise, as well as, helping you understand the factors that may trigger unhealthy habits.
  • During the first 6 months, the goal is to focus on healthy habits that can decrease your weight/BMI by 5-7%. The second goal during this time frame is to encourage participation in an exercise program with your physician’s approval. A fitness goal would be to work towards 150 minutes of weekly activity.
  • The goal during the next 6 months is to provide education to help maintain weight loss and motivation.
  • The Pre-Diabetes Education will also provide access to a nurse for coaching and support answering your questions.

How does the program work?

• Are you a newly diagnosed diabetic?
  • An easy to use monitoring device will be sent directly to your home. This device collects your blood glucose level and it sends your results to your assigned personal nurse.
• Are you struggling to get your diabetes under control? Is your A1c where you would like it to be?
  • With participation in the program, your results are monitored and specific trends can be identified. The data can be shared with your physicians as needed, or on your appointment days for records of your blood glucose readings.
• Are you having difficulty understanding how and when to take your diabetic medications?
  • Throughout the tele-monitoring program, you will have exclusive access to education materials to help you understand all aspects of your diabetes.