Insurance

[PJ Leary]

Hi,

My PPO Cigna plan authorized 3 VNA visits as requested by Dr. Murray last Friday. He actually requested 2 VNA visits daily, and 1 HHA daily to help with things like cooking.

Cigna approved the three visits over the weekend, so used one per day for am bathing and treatment. I still cannot do those thing independently. Cigna's plan was to have the nurses teach my husband how to do the treatment.

Considering the fact that these nurses have no derm experience at all, it's a good thing that I know how to instuct them, and they are able to complete my treatment. However, since there is no HHA, my husband has to tend to me, take care of out 7&10 year old, run the household, and work full time. My nurse is generally here about 2 hours in the am. When you add to the household chores all of the linens and clothing that I need laundered every day, and that the kitchen and bathrooms must be completely cleaned and disinfected every day, my dear husband has more than he can do already.

I can't speak to anyone at Cigna until tomorrow, which I shall do. Dr. Murray is pushing for the extended coverage, with clinical notes from the VNA, and photos. I've asked NPF if they can help advocate. The problem is mainly that the insurance company does not believe there is a legitimate clinical need for skilled nursing for a psoriasis patient.

I am hoping that a multi-front attack will force them to cover the VNA as I need them.

I welcome any ideas you might have as to more things I can try.

Regards,

PJ Leary

[EdR]

P.J.,

I can't think of a single approach that you aren't already taking. Just remember that a first or even second or third refusal doesn't mean that you won't eventually get the coverage if you continue being proactive.

Regards,
EdR

[KIMMY]

I wish you the best. last Monday I walked 6 miles. The pants I was wearing rubbed my p so badly, I totally flared from knee up on the back and inner thighs. by Fri It was the reddest most painful thing I could imagine I couldn't walk or wear clothes. Went to the Doctor, And went straight home to bed to my sleeping pills occluded and cool baths and Ice packs. today I wore clothes for four hours had to work, but getting a little better, My skin is so red. It never plaqued up, it was the erthodermic type silvery skin but mostly red and painful. I couldn't care for my kids either. Now my problem is my skin is so tight when I sit I think think the skin on my legs is going to crack. What are you using as an emoilent?

[PJ Leary]

Hi Kimmy,

I use Aquaphor, made by Eucerin.

Won the insurance battle, they folded quickly. Where I only had VNA 1x daily, now I have them 2x daily, and a HHA ( home health assistant ) 1x daily. There is no maximum benefit, so I am in good shape.

Goes to show you can get the coverage if you are willing to fight.

Regards,

PJ Leary