11/22/16

Health Alliance Medicare members stick with solid coverage

Herbert and Shirley Nevels of Catlin, Health Alliance Medicare membersShirley and Herb Nevels of Catlin use their Health Alliance Medicare Advantage coverage regularly—for doctor visits, for prescriptions to help manage their chronic conditions and for procedures and hospital stays when they need them.

While they understand the resource is there, what they don’t use often is Health Alliance Medicare Member Services. They’ve had little need to call with questions about their coverage or their claims.

Like 99 percent of Health Alliance Medicare members, the Nevels are sticking with their Health Alliance Medicare coverage. The Medicare Annual Enrollment Period (AEP)—when most people with Medicare choose their coverage for the following year—ends December 7.

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Working with a care coordinator is one of the Nevels’ favorite things about their Health Alliance Medicare Advantage coverage, which combines doctor’s visits, hospital stays and prescriptions into one easy-to-use package.

“She telephones us almost every week to check on us, and definitely after any surgery or procedures to see if we need any help,” Shirley said. “She helps us with any questions we might have and any needs we have. She’s very intelligent.

“We don’t call her a lot, but we know we can.”

Regularly touching base with the Nevels lets Cathy Jo Sroufek, RN, MSN, get to know the Nevels and others like them so she can help in big and small ways.

Because Herb has diabetes, Sroufek sends the couple healthy recipes to help keep his blood sugar levels in check.

And when Shirley just didn’t sound like herself, Sroufek made sure she got help.

“I was having a hard time breathing. She picked up on it. That’s how I found out I had congestive heart failure,” Shirley said. “Cathy Jo has been a big help.

“We should give her all the spotlight. She’s been terrific.”

While Herb is bouncing back after trouble with his heart, both take comfort knowing Cathy Jo and their whole care team are just a call or short drive away.

“We’d never heard of care coordination,” Shirley said. “But Cathy Jo turned out like one of the family.”

The Nevels are fine with this year’s switch to $0 Tier 1 and Tier 2 medications at Walgreens instead of Walmart/Sam’s Club, which are still in-network Health Alliance Medicare pharmacies.

“We have so many prescriptions right now,” Shirley said, adding most of their friends like and use their Health Alliance Medicare coverage.

Sroufek is glad to be part of what makes the coverage so right for so many.

“With these two, both have so many different medical issues and see so many specialties. They’re smart people, but it’s even confusing for them,” she said.

“I’m glad to help put everything together for them and other Health Alliance Medicare members.”

The relationship helps keep the Nevels their healthiest.

“Time and time again, they are so thankful for someone putting medical information in layman’s terms for them and helping them to understand,” Sroufek said. “They don’t feel judged no matter what they ask me.

“Care coordinators can help patients improve their health faster when have less to worry about.”

For more information about Health Alliance Medicare, please call 1-888-382-9771 today.