Humana Member Story

Humana Steps in to Help Member Manage Chronic Condition

Joe, a Humana member, has a medical history of uncontrolled type 2 diabetes mellitus, high blood pressure, high cholesterol and multiple sclerosis (MS). In the past, Joe has missed appointments with his primary care physician (PCP) and his endocrinologist. He’s also had multiple hospital readmissions due to diabetic ketoacidosis, a serious complication of diabetes that occurs when your body can’t produce enough insulin. To complicate things further, Joe is a smoker without a stable place to live.

Family issues left Joe without his medical supplies and stable housing, which he believes led to his last hospitalization. It was then that a Humana care manager stepped in to help Joe get a handle on his chronic conditions. The care manager began by making sure Joe had a working glucometer, understood how to check his blood sugar four times per day, and knew how to administer his insulin. Upon hearing he was running low on supplies, the care manager also called his pharmacy to get him a refill on diabetes test strips.

Once his diabetic testing supplies were in order, the care manager turned to coordinating his care after the hospitalization, arranging for transportation for follow-up appointments and making sure the transportation service had Joe’s correct phone number and address on file. The care manager then called Joe’s endocrinologist to coordinate an appointment as soon as possible, and the Humana care manager ensured she spoke directly with the PCP care manager assigned to Joe’s case. Together they were able to secure a continuous glucose monitor (CGM) for Joe as a benefit of his Humana plan, helping to prevent future hospital readmissions by enabling Joe to better monitor and control his blood sugars.