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Medical Case Management

PA Thrive medical case managers provide expert guidance and advocacy for their clients in a wide range of areas. They stay up-to-date with changing trends, policies, and programming to give clients the most accurate and current information in the field. With their assistance, people living with HIV are able to access, navigate, afford, and manage the care they need, from initial diagnosis to ongoing treatment and wellness maintenance.

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Among many other capabilities, our medical case managers:

  • Navigate insurance and healthcare coverage options for clients
  • Help individuals with HIV receive financial assistance for medical, dental, psychological, and pharmaceutical needs
  • Provide emergency financial assistance, such as rental assistance, utility assistance, and grocery assistance to eligible individuals
  • Help assess Social Security or Department of Welfare benefits for individuals with HIV
  • Conduct needs assessments for clients to best utilize community-based programs and resources and to provide referrals
  • Work directly with a 340B pharmacy to ensure clients have needed prescriptions
  • Offer housing assistance through programs serving eligible individuals living with HIV
  • Facilitate medical transportation/reimbursement for medical and dental appointments
  • Perform mental health assessments to refer individuals with HIV to psychosocial and mental health resources
  • Assist clients with HIV medical literacy to best understand their continuum of care and, if needed, communicate with a client’s medical team
  • Coordinate regional support groups for individuals living with HIV in confidential and safe environments


How do I know if I qualify for case management services?

At intake, medical case managers will conduct an income assessment to see if your income is eligible for services. To be eligible, your income must be equal to or less than 500% of the current Federal Poverty Level.

What do I need to provide my case manager to get started?

Eligible clients will need to supply their intake case manager with verification of their HIV status, identification, residency, and current income. Clients and case managers will go over client agreements and the parameters of our program. Furthermore, clients and case managers will go over confidential releases of information and perform various mental health, drug/alcohol, and risk assessments. Client agreements, releases of confidential information, and assessments will be valid for one year and will need to be reviewed and updated annually.

What do case managers do?

Our case managers are professionals who coordinate access to health and social services for HIV-positive clients. They perform continuous needs assessments, and develop, implement, monitor, and modify service care plans for clients. Furthermore, they coordinate access to a variety of community resources while ensuring quality service delivery and advocacy for client rights.

Medical case management services caseloads in compliance with the Standards of HIV/AIDS Care and Services established by the Pennsylvania Department of Health, and internal policies of the PA Thrive Partnership. In addition, all case managers must comply with PA ACT 148 and Act 59 of 2011 confidentiality laws.

How often do I need to meet with my case manager?

The case management unit meets with clients on an individualized, as or when necessary basis. Clients can meet with their case managers as often as they need to, depending on their needs. Case managers can meet with clients in the community, at their offices, or in a client’s home. The minimum meeting requirement is a quarterly visit (every 3 months) in accordance to the Pennsylvania Department of Health.

Is medical case management a free service?

Yes. Medical case management services are available to eligible clients at zero cost.

Can I get medical case management services on an “as needed basis” without being actively involved in medical case management?

At this time, clients need to be active with medical case management in order to be able to access Ryan White funding. However, clients can utilize their case manager’s assistance as much or as little as they desire, as long as the minimum requirements are being met.

Can case managers go to medical appointments with me?

Absolutely! With client consent, case managers can attend medical, dental, mental health, etc. appointments to support their clients.

Do I get to pick my case manager?

Case managers will be assigned to indiviuals based on the county in which they reside. Some counties have multiple medical case managers to work as a team to manage clients, but each client will have a primary medical case manager.

What if I don’t qualify for social assistance programs, such as SNAP benefits or LiHEAP, but still cannot afford to purchase food or heat my home?

We have you covered. Through our Patient Care department, we can provide financial assistance to clients based on need even if clients do not meet financial requirements set by other outlets.

Can I get medical case management services if I do not utilize PA Thrive Partnership clinics?

Yes, any eligible client can be in medical case management, regardless of their infectious disease provider. Many clients utilize medical case management and receive their infectious disease care in a private practice setting. Case managers can correspond with a client’s preferred physician to obtain required documentation.

My family does not know my HIV status. Can I receive services from medical case management while keeping my status confidential from my family?

Clients can correspond with their case manager in a variety of ways that best suits their confidentiality needs. Clients can request avoiding mail correspondence at their home address and/or phone calls on their home phone numbers. Case managers abide by HIPAA and Act 148, which covers sensitive HIV information. No information will be exchanged to/from case managers or PA Thrive Partnership staff without written consent from client.

How can I communicate with my case manager other than through in-person meetings?

Clients can correspond with their case managers via call, text, email, or videoconferencing platforms such as FaceTime, Zoom, or Google Meet. All case managers and case aides have agency-issued cell phones for client communications.

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