[Chris M]

Anyone ever used an insurance case manager?

by Chris M on Wed Feb 10, 2016 4:27 pm

Hello,

Our insurance company sent my husband a letter offer­ing to enroll him in their case manage­ment program. The letter says, in part, that they will assign an RN to work with him to help under­stand his illness, medications, and answer questions about his condition.

My husband has had multiple myeloma since 2011 and receives excellent treatment from wonderful staff at the University of Michigan. He's already experienced many of the myeloma and treatment complications (two DVTs; pulmonary embolisms in both lungs; fractured ribs and fractured jaw; possible ONJ; neuropathy). Originally he was in a clinical study of Kyprolis / Revlimid / dex, then was on maintenance Revlimid / dex, but was recently switched to Ninlaro (ixazomib) and Cytoxan when Revlimid / dex was no longer effective.

Has anyone ever used an insurance case manager? We are rather leery of having our insur­ance company's case manager get involved. We wouldn't want them to thwart any treatment recom­mendations my husband's oncologist makes.

Does anyone have any experiences they can share?

Thanks,
Chris M.

[KitKat225]

Re: Anyone ever used an insurance case manager?

by KitKat225 on Wed Feb 10, 2016 5:59 pm

I was assigned a case manager in late 2013. At first, I was concerned that corners would be cut, or treatment denied, in order to "save money".

Nothing could be further from the truth! She has helped get insurance approval for testing and/or new treatment. She has offered good advice on diet and activity levels to help with pain and digestive problems. She was invaluable in helping to determine what my insurance covered with respect to housing for my recent outpatient stem cell transplant, then worked on getting my expenses reimbursed afterwards.

I have come to look forward to her calls - and have called her myself, and now consider her a friend. I would not hesitate myself.

[Mark11]

Re: Anyone ever used an insurance case manager?

by Mark11 on Wed Feb 10, 2016 7:04 pm

My experience is exactly the same as KitKat's. I was assigned a case manager right after my diagnosis. She was an outstanding resource and made sure all tests, etc. were approved quickly. She was a breast cancer survivor and I viewed her as my advocate. I changed insurance companies soon after I did my allo transplant. I had such a great relationship with her that she called me about 6 months after my allo to see how I was doing even though I was no longer with the company she worked for. When I speak to newly diagnosed patients, I actually recommend they ask if they can be assigned a case manager.

[Chris M]

Re: Anyone ever used an insurance case manager?

by Chris M on Wed Feb 10, 2016 10:44 pm

Thank you very much, KitKat and Mark, for your replies. I'm glad to hear about your positive experiences!

Our insurance has been excellent approving and paying for everything so far, so hopefully if my husband decides to use a case manager, it will be an added benefit to him as it was to you both.

Thanks again and best wishes,
Chris M.