Molina Member Story
Meet Tommy
Tommy is a 51-year-old man living in Cook County. Tommy was faced with a life-threatening situation when he experienced sudden cardiac arrest. After the event, Tommy was diagnosed with multiple health conditions including diabetes, obesity, and hypertension. Tommy also had an infection in his mouth due to tooth decay which was preventing him from having necessary heart surgery. Tommy’s condition was further complicated by anoxic brain injury, which had led to verbal and cognitive dysfunction. Because of this, Tommy’s family was worried they would be unable to care for him at home and began considering long-term placement as its only option.
Getting Help
A Molina case manager began working closely with the hospital to help with discharge planning and coordinating care. The case manager worked with hospital staff and obtained Tommy’s Power of Attorney documentation and explained his health benefits and case management services. The Molina case manager helped Tommy receive dental care – clearing the dental infection – which allowed him to get his triple bypass heart surgery. Tommy’s case manager provided support each day, helped arrange discharge appointments, secured home health services as well as durable medical equipment and medications. Tommy’s case manager also helped with applications for SSDI Benefits, a LINK card, and DRS assistance. Tommy worked with his case manager to get transportation to and from his medical and dental appointments.
Now
Tommy has regained his strength and has returned to his home with in-home health services. Tommy never had to go to a long-term facility. Tommy’s sister moved in his home with him to help provide oversight and safety. Tommy’s diabetes and blood pressure have stabilized. He has now lost over 100 pounds and no longer needs a wheelchair. Tommy continues to go to therapy, which has increased his cognitive ability and his mobility. Tommy continued to progress. Tommy became independent in daily activities. He and his sister decided that he doesn’t need waiver services anymore. Tommy continues to seek the medical care her needs. “I never knew an insurance company would help me so much,” Tommy said. “Thank for you being a caring case manager.”
