Five Difficult Scenarios. Five Human Care Solutions.


Confusion. Awkwardness. Anxiety. Frustration. Fear. Difficult situations can bring up a host of emotions in you and your clients. As we discussed in our How Emotional Intelligence Could Make Your Job Easier article, being able to identify and regulate your emotions is one step in navigating tough scenarios. Here, we’ll walk through five real-world situations to show you how you can use human care, Humana’s new brand platform, to make healthcare more human and to help turn the negative into the positive. Let’s get started.

Situation #1: Your Client is Upset

Things go wrong and mistakes are made sometimes. Your client may feel justly upset. As an advocate and resource, your role is to listen and to help, whether you were involved in the reason for your client’s anger or not. Anger can be a sign of frustration or fear. It may have been triggered by feeling ignored, threatened, wronged or even powerless. Often, anger is an expression of an unmet need. When you’re working with an angry client, try to understand the meaning behind the anger and the need they have. Figure out what you can do to help meet that need.

For example, maybe they are upset because their plan is being sunsetted. They might feel like they made a bad choice or confused as to why their plan is changing. Maybe they feel like they didn’t have a say. Once you can uncover the client need or the meaning behind the anger, you can repeat it back to the client so they feel heard, understood and cared about. Take deep breaths and speak as calmly as you can. Depending on the circumstances, you can say something along the lines of “It sounds like you might be upset because this felt like it came from left field and you may be worried about being able to afford a new plan. Is that right?” These two sentences show you have been carefully listening and empathize with your client’s needs while taking the opportunity to confirm that what you’ve heard is correct. They also help clarify for you and the member the problem you need to solve. If the client confirms that this is their concern, conduct a NEADS Analysis to find out what they liked about their old plan, what they want in a new plan and what their healthcare needs and goals are. You can help them shift the story from one of loss to one of empowerment: the plan sunset is an opportunity to find a new plan that meets their needs. Be sure the client knows you’re there to help at every step of the process.

Situation #2: You’re No Longer the Agent of Record

Perhaps your client was wooed by a celebrity on a commercial and reached out to a call center instead of you to change plans. There’s no denying it: that hurts. It can feel like you’ve been slighted or even betrayed by your client. It’s fine to get upset in the short term, but in the long term, you want to understand what happened and how you can prevent it from happening in the future with your other clients. Reframe the story you tell yourself from one of betrayal or abandonment to one of learning and growth. You’ll want to step back to reassess what happened. Ask yourself how you were involved. How often did you reach out to them? If the answer is just during AEP, they might have felt the relationship was too transactional. Moving forward, you could adopt more regular check-ins with clients by following up soon after enrollment to confirm they are maximizing their benefits, have set up a doctor’s visit and aren’t experiencing any issues. Our 3-30-60-90 Day guide can walk you through the steps. You can also send out birthday cards with short, handwritten notes for an added level of personalized customer service. When you shift your perspective from closing sales to developing relationships with your clients, you’re more likely retain your Book of Business.

Situation #3: Your Client Doesn’t Have Enough Food

If you’ve discovered your client is struggling with food insecurity, you might want to begin by normalizing the situation and by showing your empathy. You might say something like “That must be very difficult. I’m glad you told me. That took courage.” Humana has several resources to help. First, call Humana member services to see if the member qualifies for food assistance. Depending on their plan, the member may also be eligible for the Healthy Foods Card, which gives users a monthly allowance to purchase groceries. For immediate assistance, you can use Humana’s zoom inTM tool to find resources such as food banks, pantries and meal-delivery services in your area. Not all members might want to receive help; respect their wishes and let them know you are there to support them should they want it in the future. You might also want to point your member to other resources from their primary care provider to federal food assistance programs. Read more in this article.

Situation #4: Your Client Can’t Afford Prescriptions

Most older adults think the cost of prescription drugs is unreasonable.1 Medicines play a critical role in curing, stopping, preventing and treating disease, especially for those living with chronic illnesses.2 Nobody should have to choose between taking their heart medication and insulin or taking their blood pressure drug and eating. You have the power to help. You can see if your member qualifies for Extra Help from the Social Security Administration. It’s a program that provides additional assistance to qualifying individuals for prescription drug costs. Your state might also offer a pharmaceutical assistance program to further reduce drug costs. Rx Calculator can help you find cost-saving solutions for your members. Humana’s Find a Pharmacy tool in the MyHumana app can help members find pharmacies with better cost-sharing options and compare drug prices.

Situation #5: Your Client Passed Away

While death is a natural and inevitable part of life, it remains sad, unfortunate and challenging. As soon as you hear the news, you will want to share your As soon as you hear the news, you will want to share your heartfelt condolences to the surviving family. Be as sympathetic and caring as you would with a friend’s passing. Kindness and tact during this time is essential, especially for surviving partners and family members who might be clients or prospects. Think about how you can help make this painful time a little easier for them. Send the family a card. Share a memory. You can gently remind them of behavioral health services for grief, depression or anxiety through their plan’s telehealth benefits. You might want to share this consumer flyer, which has tips and resources for dealing with loneliness and social isolation. In addition, all Humana members now have a dedicated, toll-free Friendship Line for emotional support, well-being checks, information and referrals you can tell them about. Be sure to update your database so you don’t inadvertently send messages or mail the deceased later on. Assure the surviving family that you are an empathetic and knowledgeable resource. You might feel powerless in the face of death but, in reality, you can offer support in meaningful ways.

Let’s make healthcare more human—together

Human care may be our brand platform, but you help make it possible. With every client check-in, you make, every service inquiry you submit, every Healthy Foods Card you help activate. Thank you for putting human care into action.

1https://www.kff.org/health-reform/issue-brief/data-note-prescription-drugs-and-older-adults/
2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045499/