Retiree Advocacy

When facing a serious health problem, it is easy to become confused and even frightened by the complicated healthcare system. You need experienced help to navigate the confusing and complex issues that sometimes arise while using your benefits. A Member Advocate is your guide through the medical maze, essentially a project manager and ally for your healthcare.

Each member has direct access to a Member Advocate who they know by name, and are always available to assist them with learning about their health benefits, options and resources. Our team of experienced Member Advocates can effectively help a member manage their healthcare by removing obstacles, providing timely access to care, delivering personalized treatments, and promoting safe, quality outcomes. We have years of experience dealing with health issues, including coordinating services with doctors/specialists, hospitals, insurance companies, ancillary providers, and other health clinicians. Whether it’s finding a doctor, resolving insurance issues, selecting a nursing home, questions on coverage, financial problems, or whatever your healthcare problem is, we are here to make your retirement experience stress-free.

Member Advocacy Service Model Highlights:

  • Dedicated call center with Member Advocates they know by name
  • Physician and pharmacy assistance on a real-time basis
  • Outbound three-way calls to Medicare, vendors, providers, pharmacies and Social Security
  • Follow-up calls to members after a healthcare date of service, to review any additional needs
  • Claims, billing and payment support
  • Help with filing applications, including Low-Income Premium Subsidy (LIPS) filing assistance
  • Assistance with pharmacy related questions such as generic availability, prior authorizations and mail-order services
  • On-site retiree educational seminars and retiree club breakfasts, allowing retirees to become familiar and comfortable with our team