This article was last updated on Oct. 26, 2022.
Have you ever left a doctor’s office confused or overwhelmed by a diagnosis? It’s not the best experience — especially when you’re probably not feeling your best in the first place! Wellmark's team of case management nurses are here to help. They're included with most Wellmark health plans, helping you get more from your health insurance.
What is a case management nurse?
Case management nurses are clinically skilled registered nurses committed to developing individualized care plans with you to make sure your needs are met. They are caring and here to help you cope with difficult health situations and make sure you don’t walk through your health concerns alone.
To understand the role that case management nurses could play in your health, consider this real-life example from a 58-year-old member who was diagnosed with stage four bile-duct cancer. After diagnosis, the case management nurse stayed in touch, at least monthly, to help the member work through ways to ease some of the many side effects of chemotherapy treatment. The nurse also prepared the member for doctor's appointments by listing current side effects, how they are being managed, and questions to ask about the condition and treatment.
Not only do case management nurses walk you through the medical side of your illness, but they're also available to help you navigate your claims, spending, approvals between levels of care, and health care coverage. They will ensure your benefits allow for the coverage you will receive, so you can focus on getting better.
What can Wellmark's case management nurses do for you?
Case management nurses can help you work through your questions or concerns about a diagnosis or recovery plan. Ask for their help with:
- Guidance toward better health choices like your diet, exercise, and taking necessary medications
- Tools and education to help you understand and work through your health concerns
- Support with understanding and navigating your health insurance benefits
- Connections to resources and people you can trust, so you can get the right care
It’s possible a case management nurse will reach out to you before you know you need one! If you’ve recently had a hospital stay or a health or drug claim that shows a complex health concern, you may get a phone call from a to learn more about you and your health care needs.
From there, you can develop a relationship with your case management nurse to create a care plan as unique as you. You can touch base with your case manager on a regular basis and as your needs or condition change.
This was the case with a 44-year-old, Spanish-speaking member who was diagnosed with thyroid cancer. A case management nurse was able to use an interpreter line to overcome a language barrier and help the member develop questions for doctor's appointments.
Case management nurses are available to you
These experienced, caring nurses are available at no extra cost to you and are part of your health plan. The program is confidential, voluntary, reliable, friendly and here to help.
To learn more about Wellmark’s case management nurses, call 800-552-3993 today.