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Our Members' Stories

In 2015, two of James’ daughters traveled to Malawi on a mission trip. Prior to travel, they both got all necessary immunizations; however, they could not obtain the very specialized anti-malaria medicine which is only available from the State health department. Therefore, they traveled without malaria pills.

Unfortunately daughter Hosanna—14 years old at the time —came home sick. They immediately went to the emergency room where she was diagnosed with malaria. Hosanna spent a week in the intensive care unit (ICU) in Morgantown, West Virginia.

During that time they were contacted by a complex case management nurse who was assigned to them and able to help them through this stressful ordeal. Not only did she answer their immediate questions, but she also:

CareFirst associate James with his wife and daughter

  • Completed a thorough assessment of the case
  • Educated the family about the help customer service can provide to prevent medication access issues in the future
  • Evaluated Hosanna’s symptoms and determined whether she needed other services such as physical therapy or medical equipment, like a walker
  • Advised on what to look for and how to know if the illness was reoccurring

The nurse confirmed Hosanna showed signs of recovery and worked with the parents on how to observe their other daughter to make sure she was not exhibiting any symptoms which can present up to a year later.

James, a CareFirst employee and member, is grateful for the help his family received.

“Having my daughter in the ICU was very stressful. Knowing someone from my health insurance was following up and clearly cared was very encouraging and helped reduce the stress of the situation. Case management is like having a knowledgeable friend who is going to walk you through the process of your illness or your family member’s illness.”