Has your insurance company suggested a case manager for your DC with MI?

[Anonymous]

Our 21 y.o. DC is still on our insurance. They took off their junior year due to an onset of mental illness in the summer prior to the school year. We just received a letter from our insurance company pushing a case manager for DC. DC has a great treatment team and no need for a case manager. Can we ignore? Interested in hearing about others' experiences and if there are any upsides to doing so.

TIA.

[Anonymous]

I don't know about mental illness but a family member was offered a case manager due to another type of serious medical issue and we ignored.

They pitched it as a way to help with red tape but it's really cost containment and management for the insurer.

[Anonymous]

Our case manager helped us identify in network residential programs, process out of network claims, find outpatient care. I was leery that it was to limit care, but it really was simply a help to us.

[Anonymous]

I work in an insurance program and I have a kid with serious health issues that have resulted in over a dozen hospitalizations and two residential treatment stays plus things like PHPs, IOPs, therapy and psychiatric outpatient treatment. So I have experience on both ends.

From a professional experience, I see so many people struggle to find care and providers. We have the ability to fast track you and get almost immediate appointments. We can get your providers to do the paperwork you need for benefits, such as FMLA, ADA and workers comp timely so your benefits aren’t unnecessarily delayed. We can find you emergency appointments. We can find you transportation to appointments.

Our case management services are separate from benefits decisions until/unless your claim is found not to be covered and then you wouldn’t be eligible for case management anymore. People are skeptical of the services but they really are beneficial to those who take advantage of them.

From a personal perspective, they were only good where the case manager knew the service area. So if we were assigned someone from Michigan, well, it wasn’t so helpful because people who aren’t from here don’t get things like that a 5 pm Friday appointment 3 miles away can be a four hour drive.

[Anonymous]

TY for the responses. Very helpful.

Appreciate if anyone else is able to weigh in here.