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Five things your Aetna Better Health care manager wishes you knew

By Eric Spitznagel

Jenna, an Aetna Better Health care manager in Virginia, describes her job in just two words: problem solving.

“It comes down to listening,” she says. “We’re here to find out what our members are missing out on, and then connect them to the medical resources they need.”

She’s one of thousands of care managers across the country who work directly with Aetna Better Health members, helping to answer their questions, recommending the most beneficial Medicaid resources and guiding them towards a healthier and happier future. 

They know how uncertain and confusing health care can be, especially with the pandemic. But a care manager can make sure you’re getting the most out of your Aetna Better Health benefits. 

“It’s important that members feel engaged during their first phone call with us,” says Laurie, a care manager from Pennsylvania. “We know they can feel alone, especially when they’re facing a health challenge. But that’s what we’re here for. I’m the friendly voice on the other end who says, ‘It’s going to be okay; I can help you.’”

Care managers can’t do it alone. They need your help to make sure you’re getting the best care possible. We asked Jenna, Laurie and several other care team members to share what they wish members knew before talking with them.

“People are afraid that if they ask for too much, if they’re too open about their medical needs, their health coverage might be taken away,” she says. “That’s simply not true.”

1. Be honest.

Luzmaria, a nurse who works directly with health care managers, says that the biggest challenge for members is getting past the fear of being honest. 

“People are afraid that if they ask for too much, if they’re too open about their medical needs, their health coverage might be taken away,” she says. “That’s simply not true.”

The more you share, the more care managers can help you. Leaving out details about your medical and financial needs can be harmful, even if this info feels embarrassing or makes you worry about denied coverage.

“We’re on your side,” Luzmaria says. “There’s nothing you can tell us that we’ll use against you. Our job is only to help, and we can’t help unless we have all the information.”

2. Make sure you have the most current contact info.

Your care manager needs a way to contact you. They also need accurate contact information for you, your loved ones and anybody they may need to talk to about your medical care.

“It sounds so basic, but it’s critical,” says Luzmaria. Phone numbers change, as do email addresses. For the people who matter in your medical care — like family members, doctors and pharmacies — do you have their most recent contact information? Before you meet with your care manager, it’s important to make sure your records are up to date.

Old or incorrect information could lead to delays or issues, but if you prepare in advance, it won’t be a problem.

“We’re here to find solutions,” says Jenna. “But we can’t fill a need if we don’t know what the need is.”

3. Get your entire care team involved.

Even before your first meeting, your care manager will talk to your primary doctor. Ashli, a care manager from West Virginia, says the more she knows about everybody providing you medical care, the better.

Do you have other providers? Are you working with a specialist? Do you have a physical therapist, dentist or psychiatrist? “I want to know about them,” says Ashli. “And more than that, I want them all involved. I want the entire care team to be connected. Even your pharmacist.”

4. It’s not just about getting better — it’s about staying well.

Jenna recently worked with an Aetna Better Health member who was very motivated to work on her weight loss goals. “She’d been going to a gym for personal training until COVID-19 happened, and then the gym closed, and she felt abandoned,” says Jenna. “She was worried about backtracking.”

But Jenna wasn’t about to let that happen. “I did some research and found that we have a weight management program in our state,” she says. “I connected her with a registered dietitian, who talked to her regularly by phone for health coaching.”

The path to better health isn’t just about medicine and doctors’ visits. It’s about making positive lifestyle changes. This can include everything from healthy eating and meal planning (a care manager can direct you to healthy and affordable food options) to fitness motivations designed to inspire better choices.

“I wish more members would ask about benefits that can change the way they think about physical activity,” says Jenna. 

5. The help you need might not be medical.

Care managers know that issues for most members aren’t always medical. The things that have the most impact on their health often aren’t related to a doctor’s visit.

Jenna recently worked with an Aetna Better Health member who, after contracting the coronavirus, was no longer able to attend the day program where he received two meals per day. Since he lived in a small, rural county, he had a hard time getting to the supermarket. And he couldn’t afford groceries.

Jenna took it upon herself to fix that. “I went grocery shopping for him,” she says. Not just for food, but also for toiletries and paper products.

The things you really need are not always medicines and tests. They might be toilet paper or milk. Don’t be afraid to ask your care manager for help.

“We’re here to find solutions,” says Jenna. “But we can’t fill a need if we don’t know what the need is.”

About the author

Eric Spitznagel is a frequent contributor to Vanity Fair, Billboard, Men's Health, Playboy, The New York Post, and the New York Times Magazine, among others. He's published eight books, including his latest "Old Records Never Die: One Man's Quest for His Vinyl and His Past." He lives in Chicago with his wife and an 8-year-old amateur scientist.

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