Ho Ho Ho! The Holiday Season is Here!
It's time to get medical visits completed before the year is over.
Hello, Everyone!
I hope you had a wonderful Thanksgiving (for those in the U.S.) and are starting to get into the festivities of the Christmas holidays and any other celebrations you have this time of year.
Since it’s the end of the year, I’ve personally been working on getting as much medical intervention as possible before January 1.
Medical insurance goes by plan year, usually it’s Jan-Jan, although sometimes it can be different year period, like Oct-Oct. My plan year resets January 1, and so I’ll have to start over with my deductible, OOP, medication copays, etc.
If you want to know more about these terms and their meanings, make a comment on this article and I’ll do an article just on the definitions. The whole thing can get really confusing.
Anyway, I’ve met my out-of-pocket (OOP) for the year, so everything (except copays) is paid at 100%. With one month to go, I want to squeeze in as much as I can before I have to start over next month.
But, it’s not going well.
Between COVID, the holiday season, and fighting everyone else who wants to do what I’m doing, I’m currently in limbo, waiting for:
My compression pump which will help with my lymphedema. I was assessed for this almost two weeks ago. I was told it would take 2-4 weeks for the approval. It’ll take another week or two to get the equipment. I’m hopeful I’ll get this by the end of the year.
Referral to an Interventional Radiologist: I was found to have pelvic congestion by Dr. Herbst—the doc who diagnosed me with Lipedema. I was referred by my vascular surgeon, but they didn’t send over a requested diagnostic (still following??). I called the Radiologist clinic, and they still haven’t received it. Once they receive it, it still needs to be reviewed before I’m even seen. I’m not sure I’ll see them before the month is up.
Referral to an orthopedic surgeon: My knees are arthritic and the increased weight is making it worse. I’ve taken Euflexxa injections for about 4-5 years, but they’ve stopped being effective. That referral was done about a week ago, but I haven’t heard yet from the surgeon. I don’t tend to have surgery, but I do want the surgeon to consult on how my Lipedema negatively affects the ability to have knee surgery.
Functional Capacity Evaluation (FCE): This one makes me angry, because I was referred to this company and requested a referral over two weeks ago, and still waiting. I’ve called multiple times, including today. I either have to leave a message, or the mailbox is full and I can’t get through to anyone. I’m not sure how to resolve this. And this eval is pivotal to getting my preauth request submitted to the insurance.
With a chronic condition like Lipedema (or any other condition), it’s constant management of different medical disciplines. You must be organized, persistent, and be the director in your own care.
I will continue to write about being your own advocate, and getting the resources and help you need for Lipedema.
In the meantime, Take Care!
Michelle