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Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company^®, Capital Advantage Assurance Company^® and Keystone Health Plan^® Central. Independent licensees of the BlueCross BlueShield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies.

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In-home care referral

Capital Blue Cross works with HarmonyCares to provide in-home primary care and care management services for eligible Medicare Advantage members with complex healthcare needs. Complete the referral form to refer one of your patients to this program. HarmonyCares will make outreach to your patient if they meet the program criteria. Eligibility is determined solely by Capital Blue Cross or HarmonyCares at their discretion. Not all individuals will qualify for services or participation.

Required fields are noted with an asterisk *.

Referring provider information

First name *

Last name *

Phone number *

Patient information

First name *

Last name *

Middle initial

Capital Blue Cross member ID *

Date of birth *

Phone number

Patient care need

What are your patient’s primary health needs, chronic conditions, or other illness related concerns? *

Submitting Information . . .

Please keep this window open until the confirmation page displays.

Thank you!

Thank you for your submission. Return to the referral form to submit another referral or close this window if you are finished.

There was an error during submission.

Please try again. If the problem continues, contact Capital Blue Cross for assistance.

On behalf of Capital Blue Cross, U.S. Medical Management, LLC d/b/a HarmonyCares, an independent company, provides this in-home service.

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