How about a non-bariatric procedure insurance question?

[Spiky Bugger]

So I got a call from a “Landmark Health,” not to be confused with the other Landmark cult-type place. I am eligible because I have United Health Care Medicare Advantage PPO. (They work with several Insurance companies, including even HMOs.) Here’s a link:
https://www.landmarkhealth.org/unitedhealthcare/

Shorter version of my experience…I am eligible for services because I have five or more chronic conditions. It would save us many trips to medical appointments. BUT THEN, they said MrSue is NOT eligible. And his “conditions” are more life-threatening than mine.

Took me a while, but then I realized that he has been getting treatment for psoriatic arthritis and dementia through the VA and his severe hearing loss is covered by both Workers Comp and the VA. And although the VA bills our insurance, UHC may not have sufficient info. UHC knows that he has pre-diabetes, cataracts, scoliosis, arthritis EVERYWHERE (although our PT says that each area gets its own dx and treatment plan), and if he is considered a good candidate and offered the new Alzheimer’s drug, https://www.leqembi.com/ , it’s (I think) a bi-weekly infusion. If they could come here and provide that service, it would be great.

Anyway, how should I go about learning which chronic conditions are covered and THEN get those entered into his UHC medical records?



Meanwhile, MiniSue has done it again! (This happened last time, too.) She got a promotion and serious pay increase. It came with a six-month probationary period. At the five-month review, employees learn if they need to “improve” in any area or if all is good. Because of that six-month thing…which includes extending that time if she takes “too much” time off…I haven’t been whining and begging for her help, even though I need it and she has PLENTY of “time on the books.”

Well, they are SO busy that they once again missed the five-month review. So she’s pretty much IN. Now she can support us!


Oh. And three people in our building have active COVID. One is next door. Aargh!

 

[k9ophile]

It's not getting much attention yet there has been a recent rise in Covid. My husband thinks he may have some long Covid conditions. And not to totally hijack your thread and make it all about me... We get Hello Fresh. It was supposed to be delivered yesterday. I didn't see it so I checked the tracking. There it was in a picture next to the garage door. Said it was delivered yesterday. What's bothering me is we went to get Chinese take out from our favorite place. I see a Hello Fresh box inside the garage and think it was from a previous delivery. The box is there so he can put in his truck for the next trip to the dump. I show him the picture and he goes out to the garage, sees the box and brings it in. He swears he didn't put it inside the garage. I know I didn't put it there. Later, he's complaining about his memory and asking about long Covid. Living with dementia or at least some form of cognitive impairment is scaring the shit out of me.

Back to you, so happy MiniSue will be able to support you and Mr. Sue.

 

[JackieOnLine]

wow, that's a lot of stuff happening with you & your husband.

I can't even begin to understand the insurance question (OMG so complicated!) but I'm happy to hear your daughter has been promoted once again.

sorry to hear there is covid in the building but not surprised. how is the building handling it? are people still eating together in the dining room?

I'm starting to see a few people with masks on at the grocery stores here.

 

[JackieOnLine]

Living with dementia or at least some form of cognitive impairment is scaring the shit out of me.

 

[southernlady]

Spiky Bugger, congratulations to MiniSue.
As far as the rest, I’m no help.
k9ophile, sending hugs.