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Care management programs are for people with more complex health conditions and who may need extra assistance and support. If you qualify, we’ll assign you a nurse care manager. Your care manager will call you to help you and your family throughout your health journey.
Their role is to find you the right care at the right time, help you manage chronic conditions, review your medications, and partner with you and your family or caregiver to navigate your health benefits.
Help you avoid another hospital stay
Your care manager can help you:
Help you coordinate your care
Our focus is on holistic support of our members. If you’re facing multiple health conditions, we’ll coordinate treatment among your doctors and provide additional resources to help you manage your conditions effectively.
Offer end-of-life support
We’ll provide an extra layer of support during end-of-life care that honors your dignity, needs and choices. Aetna Compassionate CareSM Managers provide treatment and decision support to members, families and caregivers for advanced illnesses. Your care manager can:
Help you find affordable resources to help at home
A Resources For Living® life consultant can refer you to a wide range of cost-effective and reliable services in your area. This voluntary service is part of your Aetna Medicare Advantage plan, at no additional cost. You would only pay the cost for any service you decide to use. Learn more
{Trish Lonabaugh/Nurse Case Manager, RN:}
It's more than just nursing. You have to be able to get to know someone on a personal level and get in there and let them know that you're empathetic. You truly care about them, and you want them to do well.
{Carmen Cohens/Nurse Case Manager, RN:}
So, I want members to know that I look at them like family, you know, I chose nursing to help. And when you truly have helped someone and made that difference, it's just, just a wonderful feeling.
{Trish Lonabaugh/Nurse Case Manager, RN:}
I had a call with a retiree. I said, I see that you had multiple hospitalizations last summer. Can you tell me a little bit about that? And she's like, well, I'm feeling much better from that. My only issue is I'm on too many medications. And I said, how about you grab your meds list and we'll review them, and I can tell you exactly what it's for. So once I explained to her each medication, what it was doing and that it was likely what was keeping her out of the hospital and keeping her symptoms at bay, then she was so thankful and she was like, oh my gosh, no one ever told me any of this. So I felt like in that instance that I made a difference.
{Carmen Cohens/Nurse Case Manager, RN:}
I had a member that I feel like I made an impact on their life. The member's family member called and was a little upset because the member had received a terminal diagnosis and they weren't sure exactly what to do. There was a language barrier for the member.
So, providing you know, resources that were Spanish speaking for that person and, I spent a lot of time because I could hear the anxiety in his voice, just providing him resources and education on the diagnosis.
We spent maybe about six months working together. And the beauty of it was getting the phone call that, the cancer was not visible in certain areas. And had shrunk in other areas. We do care, we do understand what they are going through and what they are feeling is important to us.
{Trish Lonabaugh/Nurse Case Manager, RN:}
My why, why I do this is to make a difference, to help people meet their health goals and make them healthier, live a better quality of life. And for me, at the end of the day, that's what it's all about.
{Amanda Lewis-Arts/Executive Director, RN:}
We are here to put the puzzle pieces together. The nurse case managers are a critically important component of what we do at Aetna. You know they are the frontline. They are the face of Aetna for our Medicare members teaching them how to take care of their health. And helping them to manage costs while providing high quality, empathetic care. That's what we're here for, and that's what we do every single day.
{Trish Lonabaugh/Nurse Case Manager, RN:}
With my first call with a member. I try and really find out where a member is, what they're dealing with, with their health, what they're insight of their disease process is.
{Carmen Cohens/Nurse Case Manager, RN:}
We also provided resources for the caregiver because if they have caregiver burnout, then they can't be good for the member.
{Trish Lonabaugh/Nurse Case Manager, RN:}
We do medication review, we look for where there may be gaps, like, do they, have transportation to get to their doctor's office, are they able to get their medications? Can they afford them? Do they need a referral to social work? And then we just ask a lot of questions. And we can offer resources and education to just help them make their health a little better.
{Carmen Cohens/Nurse Case Manager, RN:}
We have to understand their culture barriers, their religious barriers and let them understand that we are here to be respectful on that as well and being able to adapt to their life, so they can advocate for themselves and make the best decisions for their health care.
{Amanda Lewis-Arts/Executive Director, RN:}
We will work with their providers and work together to make this a seamless, easy process. At the end of the day, that's what healthier happens together means to me. It's a community. It is all hands-on deck to support members in whatever way they need.
A total health perspective – We see our retirees as people, not conditions. This holistic approach helps us deliver a helpful combination of information and support..
Personal attention – Eligible members can receive individual coaching sessions with a registered nurse or participate in group coaching.
Our National Medical Excellence Program® supports members who require a solid organ or stem cell transplant. We’ll provide you with a dedicated case manager who can help you with all of your health care needs, from the time you’re approved for a transplant through post-transplant care.
This personalized communication is designed to engage members to take action on improving their overall health and to partner with their doctor to get needed care.
Here’s what you’ll find inside to get you on your way:
How to work with your doctor to make a plan designed for you
A list of preventative services you have completed this year
What care you may need to keep you healthy
What care you may need to manage current health concerns
How to get the most from your medicine
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Please note that following this link will take you to a public Aetna site and not all links on this public page will apply to your Medicare Advantage plan.