ABSTRACT:This article discusses some of the influences that managed care policies and practices exert on family adjustment to traumatic brain injury. The task of serving families within the real constraints of time and financial resources challenges professionals to reevaluate and revise current thinking, technologies, and family service practices. This article provides theoretical and practical strategies as to how families and professionals can work within managed care practices through the rehabilitation process. Strategies are also proposed as to how families can work with their insurance carriers to maximize benefits and achieve optimal rehabilitation outcomes.