Member Case Management Referral

For members experiencing a critical illness or injury, The Health Plan provides specially trained registered nurses in case management to assist in coordinating care and services.

Member Case Management Referral

If you are a member experiencing a critical illness, injury, or behavioral health problem and believe you could benefit from The Health Plan Case Management Program, please fill out and submit the form below.

You can also contact the case managers by calling our Medical Department at 740.695.7644 or 740.695.7643 or toll-free at 1.800.624.6961, ext. 7644 or 7643.

Member ID begins with an "H"
Do not send sensitive information through this form.