When you’re facing a cancer diagnosis, managing your care can feel overwhelming. Add in a language barrier, and navigating the healthcare system becomes even more difficult.
That was the case for a 55-year-old Amazon employee living in Waco, Texas. Spanish is his first language, and while he uses an interpreter during medical visits, he was unsure how to speak up effectively when some of the side effects from his chemotherapy medication became too difficult to bear.
Connecting with case management
The member was referred to Premera’s Case Management program after a new dosage of his cancer medication was denied by his pharmacy. Although the drug had been previously approved, the lower dose required a new authorization. That denial prompted Premera’s case manager to intervene immediately, contacting the pharmacy benefit manager and getting the new prescription approved the same day to avoid any interruption in care for the member.
A few weeks later, the member reached out again to his case manager again. Through a Spanish interpreter, he explained that he was experiencing severe pain in his throat and stomach from the medication and had not been able to eat. His next oncology appointment was still weeks away, and he didn’t know where to turn for help in the meantime.
Compassion and advocacy
The case manager responded to the member’s urgency with urgency of their own, contacting the oncology clinic on the member’s behalf and advocating for an earlier appointment.
At first, the receptionist said nothing was available. The case manager continued pushing, asking for a nurse to be consulted or for the member to see another available provider. With Premera’s case manager on his side, the member’s wait for another appointment went from weeks to hours, and he was seen by another oncology provider at the clinic the following day.
At that visit, his care team decided to pause the chemotherapy for one week. Within a few days, the member’s symptoms had improved. The throat pain was gone. The stomach pain eased. And he was finally able to eat again. Today, the member is continuing his cancer treatment with improved symptom management and peace of mind, knowing that support is only a phone call away.
Care centered on the person
This story is a powerful reminder of why Premera’s Case Management program exists. It’s about more than just helping with prescriptions or appointments, though that work is important.
Ultimately, Premera’s case managers work to make sure our members are seen, heard, and supported, no matter what language they speak or what barriers they face. Because healthcare should never be out of reach. And no one should have to navigate it alone.
To learn more about your Premera health plan benefits and how you can get the most out of your Premera plan, visit our website to sign in or create an account today.
