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Member Care

Advance Directives

It’s important for our members to be a part of their healthcare choices. It may be hard to think about, but your loved one should decide what their healthcare choices are if they become too sick to make those decisions.

Discuss creating a living will or designating a Power of Attorney with your loved one. This information can be provided to you and the member’s Care Team, and doctors. The Wellcare Prime by Absolute Total Care (Medicare-Medicaid Plan) Member Handbook has more information on advance directives. Please visit the Resources/Materials page to view the Member Handbook.

When to Contact your Care Coordinator

Your loved one’s care coordinator is there to support you. They are an important part of the Care Team. There are many reasons you may need to be in contact with them. Some examples of when you should call your loved one’s care coordinator are:

  • Change in condition 
  • Emergency (ER) visit or hospital admission 
  • Fall or injury 
  • Not all agreed upon services are being provided 
  • New diagnosis or medication 
  • Assistance with finding or changing providers 
  • Difficulty scheduling an appointment 
  • Change in living environment or work arrangement for loved one 
  • Need for additional training 
  • Durable Medical Equipment (DME) in need of repair or replacement

When to Go to the Emergency Room (ER)

Your loved one should be taken to the ER in an emergency situation. An emergency situation is when a life could be in danger. It is also when a person could be permanently hurt or disabled without care.

Examples include:

  • Difficulty breathing
  • Severe chest pain
  • Severe bleeding
  • Sudden changes in being able to move, speak, or feel sensations in your arm or leg
  • Poisoning
  • Fainting
  • Sudden mental status changes
  • Coughing or vomiting blood
  • Sudden onset of a severe headache, especially the “worst headache of your life”
  • Suicidal or homicidal thoughts
  • Severe vomiting or diarrhea
  • Behavioral health emergency

Severe injuries also need immediate care. Examples are:

  • Burns
  • Cuts
  • Extreme joint pain or swelling
  • Broken bones

If needed, go to the closest emergency room. If the person cannot move or it is not safe to move them call 911.

After getting care, your loved one should always call their doctor within 24 hours, and schedule a follow up visit.

If your loved one might need treatment soon but may not be in a life or death situation, you can visit an urgent care center. Or call your doctor to receive advice and schedule an appointment.

Respite

Caregiving can feel like a big job. Everyone needs a break at times. This can be helpful for you and your loved one to give you time to connect with others and recharge.

Respite can range from a 30-minute break to taking a short vacation. Call your loved one’s care coordinator to learn more. You can explore the options through your local Area Agency on Aging.

Last updated:  10/01/2024
Material ID:  H1723_WEBSITE_2025_Approved_11042024

Wellcare Prime by Absolute Total Care (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and South Carolina Healthy Connections Medicaid to provide benefits of both programs to enrollees.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Wellcare Prime Member Handbook.

Out-of-network/non-contracted providers are under no obligation to treat Wellcare Prime members, except in emergency situations. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services.

Other pharmacies/physicians/providers are available in our network.

If you need help finding a network provider and/or pharmacy, please call 1-855-735-4398 (TTY: 711) or visit mmp.absolutetotalcare.com to access our online searchable directory. If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above, request one at the website link provided above, or email ATC_SC_MMP@centene.com.


Last updated:  10/01/2024
Material ID:  H1723_WEBSITE_2025_Approved_11042024

Wellcare Prime by Absolute Total Care (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and South Carolina Healthy Connections Medicaid to provide benefits of both programs to enrollees.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Wellcare Prime Member Handbook.

Out-of-network/non-contracted providers are under no obligation to treat Wellcare Prime members, except in emergency situations. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services.

Other pharmacies/physicians/providers are available in our network.

If you need help finding a network provider and/or pharmacy, please call 1-855-735-4398 (TTY: 711) or visit mmp.absolutetotalcare.com to access our online searchable directory. If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above, request one at the website link provided above, or email ATC_SC_MMP@centene.com.