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“We are here to open doors and give members the knowledge and resources they need so that they can live as healthy and happy as possible.”

During a welcome call, one of our new members told his health plan’s care coordinator that he had been living without electricity for over six months, and he also had no running water at his home. This led to him staying outside during the summer months under shade, often until late into the night, because it was cooler there than in his house. This member had a history of heart problems and was also underweight due to lack of food. His care team worked with a non-profit to help get his electricity back on. His health plan care team also provided food, water, and other supplies in order to help him move back into his home. His health plan says, “This is what caring about people is. We are here to open doors and give members the knowledge and resources they need so that they can live as healthy and happy as possible.”

“Unbelievable” how much the health plan and care team have been able to do for her mother

One Healthy Connections Prime member, a woman with dementia, high blood pressure, and vertigo, lives alone. Her children support her but they live at least 45 minutes away. The MMP care team noticed that the member was experiencing progressive memory loss, had suffered some falls, and was forgetting to take her medication. She was also having trouble maintaining her home. The health plan worked with the member and her family to help her get waiver services, which are available to all Healthy Connections Prime members who have a medical need for them. The woman began receiving incontinence supplies, 15 hours a week of in-home personal care, support with taking medication, home-delivered meals, and a personal emergency response system (push-button fall alert system). The member and her children were given information about transportation to medical appointments, and she began receiving physical therapy in her home. One of her daughters expressed that she felt blessed to have the support of the Healthy Connections Prime program and stated that everything it is “unbelievable” how much the health plan and care team have been able to do for her mother.

Feeling valued by your health plan

One of our members called his Healthy Connections Prime plan with questions about a letter he had received. On the call, he explained that he is disabled due to past strokes and had questions about the doctors available in his area. He was also having trouble paying for over-the-counter (OTC) items on his disability income. The care coordinator helped him find a doctor and told him about the extra benefit their plan offered to purchase a certain amount of OTC items for free each quarter. The member stated that would be a huge help to him and told his care team how happy he was to be a part of this health plan because he felt valued as a member.

Waiver support services provide helpful relief to the caregiver, and in turn results in better care for the member

A member with high health needs required 24-hour care. Her daughter is her primary caregiver, working extremely hard to support her mother. Initially her health plan care coordinator had been unable to convince the daughter to apply for waiver support services available under the CLTC program as the daughter believed it was her job to help her mother. Ultimately, the care coordinator was able to convince the daughter to sign her mother up for waiver services, and later contacted the health plan to thank them for convincing her to ask for help. She explained that she used to think she would be taking from a system that was in place to help those who did not have anyone in their family to help them. The case manager assured her that with her mother's condition, she easily meets the necessary criteria to have access to the services. The daughter was grateful that she received some necessary help, which would help her better care for her mother.

Mail order pharmacy service makes medications affordable

A new Healthy Connections Prime member was not sure she would be able to afford her prescription medicines, even with a $0 copay, because the pharmacy her doctor used charged a delivery fee. The care coordinator helped the member sign up for the plan’s free mail-order pharmacy service and worked with the provider to fax a new prescription. The member was very happy to receive her first no-cost delivery of her medicine shortly afterward. and she said she did not know what would have happened if the care coordinator had not come along.

Supporting member with language barrier to receive the services he needs

One member lives with his extended family, who all help to care for him. However, none of the family members are fluent in English and this language barrier created difficulties for them when speaking with people outside of the family. During a recent call, the MMP care coordinator used an interpreter and spent a great deal of time explaining to the member and his family all of the services available to him from the MMP. The family was able to share their thoughts, care questions, and concerns and learn more about the MMP’s benefits. The member and his family were very appreciative of the care coordinator and their willingness to engage an interpreter so they all could communicate. They thanked their health plan for not giving up on them.


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