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Aetna® Medicare Advantage (MA) plans offer a bounty of benefits to keep you on your path to better health. But with so much complexity in the health care system, sometimes you need a little extra help. If you qualify, Care Management can help you achieve a connected approach to health and wellness.
We spoke to Sherrie McNutt, executive director of Case Management Operations at Aetna, to learn more about the Care Management program. “We provide our Medicare members with advocacy and support in helping them achieve their best health, whatever that may look,” says McNutt. Here’s what you should know about Care Management.
“We provide our Medicare members with advocacy and support in helping them achieve their best health, whatever that may look.”
Helping you navigate the health care system
Nurse case managers are the heart of our Care Management program. They’re specially trained to help you use your benefits efficiently and wisely across the health care system.
Nurse case managers support you by assessing and creating a care plan that’s person-centered and focused on your goals.
Sometimes you may need help scheduling appointments, such as those for medical MRIs, CAT scans, X-rays and other diagnostic tests. Nurse case managers are there to help with scheduling and getting the results over to the necessary providers. They can also help you get specialist referrals or connect you to pharmacists and mental health providers.
All along the way, nurse case managers ask the important questions of physicians, nurses and providers on your behalf. And, ultimately, they make sure certain issues worrying you are taken care of in a succinct and holistic manner.
Connecting you to Resources For Living
If your clinical outlook is complex, nurse case managers will also help you get connected to the Resources For Living® program.
If you need community resources, nurse case managers work within the community ecosystem. They link together all the resources available to you. “We put it all together with their clinical picture,” says McNutt.
That means nurse case managers can connect you with social workers — for example, if you need Medicaid paperwork filed with the state or extra long-term care benefits. They can also connect you with dieticians or trainers so you can live an active life.
Even details like making sure you have enough food in your home or transportation to and from appointments can be facilitated by nurse case managers.
Supporting you during the ‘new normal'
During these difficult times, nurse case managers continue to maintain a strong line of communication with members by telephone or email. They can be a resource for you, whether you have questions about chronic care management, needing to see a doctor or responding to new health developments.
For example, Field Case Manager Teresa Herron recently helped a member named Lillie*. Lillie said she declined to participate in Care Management programs in the recent past. But Teresa explained she was calling to check on how Lillie was doing during the current COVID-19 crisis and expressed that Aetna cares for her.
Lillie immediately brightened up! She began to tell Teresa her history, including two episodes of breast cancer and depression, which she’s had for 30 years. Lillie also mentioned she has severe arthritis and suffers with fibromyalgia. Lillie’s been worried nonstop over the fear of getting the COVID-19 virus. But she’s doing what she can to stay safe.
Teresa took this opportunity to review important information about COVID-19 with Lillie. Teresa also confirmed Lillie has access to food, supplies and her medicine. Lillie has plans to see her psychiatrist soon through a televisit. Teresa's call came at just the right time for Lillie. Lillie expressed that she needed to talk to someone about her feelings and was touched that Teresa was asking about her well-being. Lillie agreed to a follow-up call and expressed deep gratitude for Teresa's call. She said, "I am touched that you and Aetna care."
Now what?
The member is at the center of everything we do at Aetna. Care Management is a great tool for knocking down barriers in the health care system and helping you age actively. “The member is truly our driver, and we all have the same focus and goal,” says McNutt. “It's about what's best for our members.”
*These are fictitious characters and stories inspired by member testimonials. They are used for illustrative purposes only.
Need help?
Call us at 1-833-329-0412
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Need help?
Call us at 1-833-329-0412
${tty} to chat about any Medicare questions you have.