Health Service Definitions
Routine or primary care
Primary care is a health service you get from a primary care provider or primary care manager (or PCM) during a doctor’s visit. Some of these services include:
- • Routine care, like an annual physical exam
- • Medical treatment for nonemergency or nonurgent care
- • Follow-up care if you have ongoing medical problems
- • Preventive health care, like immunizations and allergy shots
- • Family planning
- • Patient education and counseling
Primary care also includes medically necessary diagnostic laboratory and X-ray procedures and tests. Primary care is used to treat adults and children, including infants and newborns.
Preventive care services include period health screenings, checkups, and other medical procedures to prevent illnesses, disease, or other health problems. You should be able to get these services from your health care provider.
Substance abuse and mental health
Mental health and substance use disorders can affect anyone. These illnesses affect a person's ability to function. Substance use disorders occur when the use of alcohol or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home.
Urgent care and emergency care
Urgent care is medically necessary care that you need for a sudden illness or injury that isn’t life threatening. It does require immediate attention from a medical professional to avoid complications, like infection.
Emergency care, on the other hand, is care you need to treat a serious medical condition immediately. This includes a mental health emergency. An emergency is a threat to either:
Medical equipment and supplies
Medical equipment and supplies are ordered by a health care provider for everyday or extended use. This may include items like oxygen equipment, wheelchairs, crutches, or blood-testing strips for diabetics.
Tests and X-rays
Medically necessary clinical diagnostic laboratory tests are ordered by a health care provider. Tests are done to help diagnose or rule out a suspected illness or condition. Preventive tests and screenings help to prevent, find, or manage a medical problem. An X-ray is an imaging test to look at the bones in your body.
Specialty care is advanced care you get from a medical professional who is a specialist. This type of care is for diagnosis and treatment of diseases. If your primary care provider or manager isn't qualified to provide this care, he or she may refer you to specialist who can.
Why Would I Need Case Management?
The need for case management services is determined through a collaboration between you, your family or caregiver, your health care team, and your provider. This collaboration will include a comprehensive assessment of your health, psychosocial needs, and use of health care services and resources.
Case management can help by:
- Coordinating your care.
- Assessing, planning, and facilitating services for you.
- Evaluating your options.
- Advocating on your behalf.
You or your family member may need case management if you have:
- Instability with chronic health problems
- A serious terminal illness
- An increased need for different provider specialties
- A branch of medicine or surgery that a doctor specializes in. due to multiple diseases or conditions
- A need for more support and education during a critical period
Who are Case Managers?
Case managers are usually nurses or social workers who can help you and your family figure out complex health care and support systems. They will work with you to coordinate the services and other community resources you need
They can help:
- Provide advocacy, support, and education
- Reduce burden and streamline appropriate utilization of care
- Partner with members of your healthcare team to assist in coordination of your healthcare needs
- Monitoring for progress and desired outcomes
A dental visit means being examined by your dentist, who diagnoses and treats conditions that can range from routine to extremely complex. Members of the dental team may include a dentist, dental assistants, lab technicians, and dental hygienists.
Services may include:
- Exams, cleanings, fluorides, sealants, and X-rays
- Fillings, including white fillings on back teeth
- Root canals
- Gum surgery
- Oral surgery and tooth extractions
- Crowns and dentures
- Orthodontics and braces
Pharmacy services provide prescriptions drugs to patients. You can use a pharmacy service to get your prescription either in-person or by mail.
Vision coverage is a health benefit that may cover some of your vision care. This may include eye exams and, sometimes, glasses. Your vision provider may provide these services for both adults and children.
Women's health and pregnancy
Women's health refers to health issues that are unique to women, including pregnancy, menopause, and/or conditions of the female organs. Be sure to get early and regular prenatal care to ensure you have healthy pregnancy. You should also get recommended breast cancer, cervical cancer, and bone density screenings.
Men's health refers to health issues that are unique to men, such as prostate cancer, high risk of heart disease, and/or conditions of the male organs. Many of the major health risks that men face can be prevented or treated with early diagnosis.
Children’s health includes physical, mental, and social well-being. It’s important to closely monitor your child’s health as they develop. Regular visits to the doctor can detect or prevent your child from experiencing health problems.
Medical readiness assesses a service member’s health and fitness. Your readiness determines if you’re mentally and physically able to serve and be deployed.