Roger lives with his wife in a rural part of the country. Though it’s a drive to go to the store or visit the doctor, they enjoy life on their ranch—surrounded by their animals, plenty of fields and trees, the backdrop of mountains and lovely sunsets.
Roger was recently diagnosed with prostate cancer, but he’s responding well to his radiation treatments and remains in good spirits. He feels their ranch is a natural remedy and it makes him feel better to sit on their porch and enjoy the sights and sounds around him.
The biggest problem is finding a supplier for his catheters. Due to his treatment, Roger needs a specialized catheter he can only get from a durable medical equipment (DME) provider. Since they live in a remote area, there aren’t many DME providers around—the closest he can find is a long drive and not even in their network. The cost of the catheters is an added expense on top of his cancer care.
Help from Meritain Health®
Roger and his wife have health care benefits through Meritain Health. A client advocate reviews his case and realizes the burden the couple has been facing with their long journeys to the DME provider, plus the higher out-of-network cost. She gets to work right away to find a better solution.
The client advocate spends some time doing research and contacting DME providers near Roger’s home. Finally, she is able to find one that’s in his provider network. This would save him money on the cost of the catheters. Even better, the provider offers direct shipping—which would allow Roger and his wife to avoid the drive.
The client advocate contacted Roger and let him know the good news. He was very pleased to hear he’d be able to save money to help him cover the cost of his treatments. Plus, without the long drive to the DME provider, he’ll have more time to rest and recover after receiving them.
Roger is currently doing well and grateful for the opportunity to continue enjoying the life he loves. He’s looking forward to the future and spending long, sunny days on his ranch.
This story is based on an actual member experience. Names and information have been changed to protect the member’s privacy.
This material is for information only and is not an offer or invitation to contract. Health benefits and health insurance plans contain exclusions and limitations; see your plan documents for complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary and are subject to change.