Nurse Care Manager Helps Member Living with Kidney Disease

Humana Medicare Advantage (MA) member Lori is one of an estimated 37 million Americans who live with chronic kidney disease. Because of kidney damage, Lori’s left kidney had been removed. So when she began experiencing familiar kidney stone pain on her right side, she went straight to the hospital emergency department. Lori’s experience in the hospital was harrowing. She developed sepsis and had to be intubated to help her breathe. Admitted to the intensive care unit, Lori stayed in the hospital for four days.

After going home from the hospital, Lori contacted her insurance agent, Carol Eckelkamp, to ask about the premade meals that she knew Humana offered as a benefit of her MA plan. Mom’s Meals are part of Humana’s Well Dine Post Discharge program which provides fully prepared meals for eligible members after hospitalization. The number of meals provided is dependent upon a member’s medical plan.

After spending time in the hospital, eating balanced, nutritious meals may help make a difference in recovery and overall health. Within days of hospital discharge, Susan Robirds, RN, Certified Care Manager* contacted Lori. “Susan helped to get the ball rolling for the meals,” said Lori. “She was a very caring voice in my world where everything else was chaos.”

Lori reports that she “saw no less than 10 doctors while in the hospital” as she went back for five outpatient procedures and hospital stays over the course of two months. During that time, Susan kept in touch with Lori and checked on her progress, providing support and guidance. 

When Lori was worried about her copay for a laser lithotripsy procedure, Susan helped her understand how a benefit of her MA plan—available only to chronically ill members who are participating with care management services and meet program criteria—could help members pay for eligible healthcare and non-healthcare expenses at participating locations. Allowance availability and amounts vary by plan and location.

“It was amazing that Susan knew just what I needed and helped me navigate the entire process [so I didn’t need to worry] as I was checking into the hospital to get my lithotripsy done,” said Lori. “Talk about perfect timing!”

After recovery, Lori wrote a letter to express her gratitude for the personal attention and reassuring care she received. “Because of Susan's kindness, knowledge and HUGE caring heart, I wanted Humana to know how wonderfully Susan helped me at my time of need,” said Lori. “Susan exudes the best part of what Humana has done for me!”

Humana’s nurse care managers help our members every day in ways that encourage them to take control of their health, know when to seek care and help them navigate benefits. If you are interested in making a difference in patients’ lives, visit careers.humana.com to learn about open opportunities. 

The benefits mentioned are a part of a special supplemental program for the chronically ill. Not all members qualify. Allowance amounts cannot be combined with other benefit allowances. Limitations and restrictions may apply.

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Your results may vary. It may not be typical to improve health conditions by taking the actions Lori did.

*Care managers are assigned only to members who meet eligibility criteria and agree to participate in one of Humana’s Care Support programs.