Benefits Overview

Absolute Total Care offers health insurance plans with comprehensive healthcare services that suit the needs of families and individuals throughout South Carolina.

View some of Absolute Total Care's benefits below. You can also view more information in our Member Handbook.        

A behavioral health condition, also called a mental health condition can happen to anyone. Many are medical problems just like cancer or heart disease. Left alone, mental health problems can get worse. Treatment may include talking to a therapist or taking medicine. If you need help finding a behavioral health provider, call Member Services at 1-866-433-6041 (TTY: 711).

Care coordination and disease coaching are part of your health benefits and are provided to you at no cost. Absolute Total Care pays for these services. We provide services for many conditions, such as asthma, diabetes, COPD, high-risk pregnancy and more.

For more information, visit our Health & Wellness section or follow the links below:

Asthma
Asthma and Your Child
Diabetes
Flu Prevention

If you have any questions, please call Member Services at 1-866-433-6041 (TTY: 711).

As an Absolute Total Care member, you can choose who you see for your healthcare needs from our network of providers. We have many providers for you to choose from. You can find the right provider for you by using our Find a Provider Tool. If you need help choosing a provider, call Member Services at 1-866-433-6041 (TTY: 711).

To view information about the quality of hospitals in your area, vist Hospital Compare. View the South Carolina Hospital Accreditation List to find hospital's accreditation information.

Some providers don’t offer family planning services due to moral or religious grounds. View the Moral and Religious Objection List to find Absolute Total Care providers who don’t provide these services.

 

Absolute Total Care covers unlimited doctor visits with a $0 copay!

You don't have to wait until you are sick to visit the doctor. Preventative care visits and annual physicals for adults are also covered with a $0 copay.

Regular child check-ups up to age 21 are covered by Absolute Total Care. These doctor visits should occur at the below ages.

  • Birth
  • 3 to 5 days
  • 1 month
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 24 months
  • 30 months
  • 3 years
  • 4 years
  • Every year until age 21

Children also need a blood lead test at 12 and 24 months of age. We cover this! After 24 months, children who are high risk will need a blood lead test each year for ages 3 to 6. 

Use our Find a Provider Tool to search for a provider in our network.

NurseWise® is our 24/7 health information line. No matter what time of day it is, you can always call our nurse advice line. When you call, you’ll speak to registered nurses who can give you advice on any health-related problem. This service is available to you at no cost!

They can help you:

  • Find a doctor
  • Determine the best place to go for care – whether that be your doctor, the emergency room (ER) or somewhere else. For more information on the ER, please visit the Emergency Room page in our Health & Wellness section
  • Give advice on medical and mental health concerns
  • And more!

You can also save time by allowing our nurse line to help you determine the most appropriate level of care to meet your healthcare needs.

Remember, you can call Absolute Total Care and speak to a nurse. Call 1-866-433-6041 (TTY: 711) and say “Nurse,” then press 9.

Through our MemberConnections® program, we can help you get the support you need. A MemberConnections team member can talk to you over the phone. They can also visit your home. They can talk to you about things like how to choose a doctor, plan benefits and living healthy. They can also connect you to community social service programs. These programs will help you with food, housing and clothing.

Makena Treatment

Have you had a previous premature delivery?  You may be able to get Makena treatment.  Makena is a medication that can assist with prevention of premature birth.  Care Manager nurses are there for you throughout Makena treatment.  They are there 24 hours a day, seven days a week. Call Member Services at 1-866-433-6041 (TTY: 711) for more information on this program. Contact your primary care provider to see if Makena is right for you. 

Are you pregnant? Tell us right away!

Call Member Services at 1-866-433-6041 (TTY: 711). You can also login to your Absolute Total Care account or visit the Member Handbook and Forms page to fill out the Notification of Pregnancy form.

Start Smart for Your Baby® (Start Smart) is our special program for women who are pregnant. We want to help you take care of yourself and your child throughout your pregnancy. Our Start Smart staff can answer questions and give you support if you are having a problem. We can even arrange for a home visit, if needed.

If you go to your prenatal and postpartum visits, Absolute Total Care will give you up to $60 on your CentAccount® card. This is our way of saying thank you for taking good care of yourself and your baby!

High Risk Pregnancy

Absolute Total Care also has a High-Risk Pregnancy Nurse Care Management Team to provide guidance and assistance to our pregnant members who have complex pregnancy needs or other pregnancy-related complications. We want you to see your doctor as soon as possible after you find out you are having a baby. Getting early and ongoing prenatal care can help you have a healthy baby. Absolute Total Care has a High-Risk Pregnancy Care Management Team to help you get the services you need and coordinate those services if you have a high-risk pregnancy. When you see your doctor about your pregnancy, ask the doctor to send us your Notification of Pregnancy Form and if you need a referral to our High-Risk Pregnancy Care Management Program. Your doctor can arrange for our nurse to call and assist you in getting needed services and coordinating care for yourself and your infant. You may contact our High-Risk Pregnancy Care Management Program directly by calling 1-866-433-6041 and ask to speak with an OB Care Manager. 

Interpreter services are provided free of charge to you during any service or grievance process. This includes American Sign Language and real-time oral interpretation.

If you need something translated into a language other than English, please call Absolute Total Care. We can also provide things in other formats such as braille, CD or large print.

If you need an interpreter for your medical appointment, contact Absolute Total Care from 8 a.m. to 6 p.m. (EST), Monday through Friday. Please call us at least 72 hours before your scheduled appointment. We will arrange for an interpreter to be at your appointment. 

South Carolina’s Medicaid Transportation program provides non-emergency transportation for members. If you need to schedule a ride for a non-emergency reason, please call the reservation line for the region that your county is located in. Transportation must be arranged at least 72 hours before your appointment. 

Region 1

Abbeville, Anderson, Cherokee, Edgefield, Greenville, Greenwood, Laurens, McCormick, Oconee, Pickens, Saluda, Spartanburg

Region 2

Aiken, Allendale, Bamberg, Barnwell, Calhoun, Chester, Clarendon, Fairfield, Kershaw, Lancaster, Lee, Lexington, Newberry, Orangeburg, Richland, Sumter, Union, York

Region 3

Beaufort, Berkeley, Charleston, Chesterfield, Colleton, Darlington, Dillon, Dorchester, Florence, Georgetown, Hampton, Horry, Jasper, Marlboro, Williamsburg

Statewide number for nursing homes and medical facilities

1-866-420-6231

Website for Health Care Facilities

http://facilityinfo.logisticare.com/Default.aspx?alias=facilityinfo.logisticare.com/scfacility&

Call Member Services at 1-866-433-6041 (TTY: 711) if you are having a problem scheduling a ride to your medical appointment. Member Services will assist you in contacting your Transportation broker to arrange transportation.

Absolute Total Care covers ambulance transportation to the nearest hospital for emergency situations. You do not need to contact Absolute Total Care before using an ambulance for emergencies.

In addition to routine eye care, Absolute Total Care covers one complete pair of glasses (frame and lenses) every 12 months for members ages 20 and younger.

You take care of your health; we offer a way to earn reward dollars when you complete certain healthy behaviors.

Earning and using rewards is easy

Step one: Complete a healthy activity.

Step two: Reward dollars will be put on your CentAccount® rewards card after we receive the claim for your healthy activity.

Step three: If it's your first reward, a card will be mailed to you. 

Step four: Spend your rewards dollars at one of the following participating stores:

  • CVS Pharmacy
  • Dollar General
  • Family Dollar
  • Meijer's
  • Rite Aid Pharmacy
  • Walmart
  • Fred's Super Store
     

You can buy hundreds of items with your card

Here are some of the items you can buy:

  • Baby care
  • Healthy groceries
  • Over-the-counter (OTC) medicines
  • Personal care

For a complete list of items you can buy, log in to your member account. Remember, this card is not a credit card. It already has funds on it. Keep the card after you use it. As you earn more rewards, they will be added to this card.

Earn rewards

Everyone can earn:

  • $5 - For getting an annual flu vaccine (One per flu season September-April)
  • $10 - For submitting a completed Health Risk Screening. Call us at 1-866-433-6041 (TTY: 711) to complete the screening. (One reward per lifetime).
  • $10 - For an annual well care visit with your primary care doctor. (One per calendar year; age 21-64). 
  • $20 -  For annual comprehensive diabetes care (Must complete all of the following once in the calendar year; age 18-64):
    • HbA1c test
    • LDL cholesterol test
    • Kidney screening
    • Retinopathy screening (dilated eye exam)

Women can earn:

  • $10 - For an annual cervical cancer screening. (One per calendar year; females age 21-64).
  • $10 - For an annual breast cancer screening. (One per calendar year; females age 50-64). 
  • $15 - For the third, sixth, and ninth prenatal doctor visit*. ($45 maximum). 
  • $15 - For a postpartum doctor visit*. (Must be completed between four to six weeks after delivery). 

*To be eligible for these rewards, you must notify us you are pregnant prior to having your baby by submitting a completed Notification of Pregnancy Form, which can be found on the Member Handbook and Forms page. Prenatal visit count begins after we are notified you are pregnant.  

Children can earn:

  • $5 - For each of the following immunizations. (Age birth-24 months):
    • DTaP
    • Hepatitis A
    • Hepatitis B
    • HiB
    • IPV
    • MMR
    • Pneumococcal Conjugate
    • Rotavirus-2
    • Rotavirus-3
    • VZV
  • $10 - Per infant well care visit with the child's primary care doctor up to 15 month old ($50 maximum). These visits are recommended at 3-5 days old; before 30 days old;and at 2, 4, 6, 9, and 15 months old.
  • $20 - For the sixth infant well care visit with the child's primary care doctor up to 15 months old.
  • $20 - For an annual well care visit with a primary care doctor. (One per calendar year; age 2-20). 
     

Already earned a reward and recevied a card?

To activate your card, go to www.myotccard.com or call 1-888-682-2400. 

To check your balance, log into your member account.

The card cannot be used to buy alcohol, cigarettes, tobacco, firearms or ammunition.  All rewards expire one year (365 days) from the date the reward is added to your card.  If you do not use or earn more rewards for 12 months, your card will close.  When your card closes, you will lose any remaining balance.  Your card expires 60 days after your coverage terminates.