Good News - Found out this today!

[~Brian~]

As many of you know, there are a lot of things that you may not be able to get covered when you are incontinent.  This morning, I called my case manager on a whim, and she called me right back, and we discussed incontinence supplies and what they would cover, because some of the rules regarding flex funding have changed in 2022.

as of now, they cover my wipes, my disposal bags, and mostly anything that I need for incontinence care, minus the sprays and powders and other things that may be needed for topicals. We discussed the irony of the situation because they get this funding that I use from the state of Vermont, but the state of Vermont will not cover wipes for adults. This is why I need to go to home health and hospice for this particular expense. So, they cover basically anything that Medicaid will not cover. I found out this morning that they took $50,000 away from funding for flex funding in 2022. This is a large chunk of funding, but I was presently and pleasantly surprised by the following.

we discussed the fact that I need disposal bags for some of the diapers that I remove. These are the ones that are the messy ones that I do not want to end up touching or end up throwing into my disposal can without having a way to mask the odor and deal with the mess. Prior to 2020, there was a particular type of bag that was called a “Heaven scent disposal bag, Which NORTHSHORE carried for a while, And now they make their own. I had a discussion with my case manager, and asked her to cover the expense of $239 for 1000 of these bags. This will cover the entire year, and I also asked her last week to purchase me another set of one year supply of the wipes from NORTHSHORE the extra large size. Both of these were approved. Now I won’t have to worry about not having disposal bags should I have a really messy change, or if I have to Clean up additional mess. I was pleasantly surprised that they covered both without problem, because they have covered them in the past for me, so this is not an issue. Now I will not have to worry about not having any wipes or any of the disposal bags or any of the other things such as the canister or the accord bags either.

NORTHSHORE now makes scented Disposal bags, and I have been told that as long as it makes sense they will cover anything I need. This means that my case manager will be able to order anything that I need, so long as it’s been prior approved. Most of the things I have asked for have been necessities, and have been approved already, so this is not an issue. Thank God that I have this available, and I have dodged this bullet.  Because of the way NORTHSHORE sells these, and because I got the largest size, I will not need to have her order anymore for at least a year unless I need more, and if that is the case then I will be able to do this.

NOW FOR THE SHOCKER:  I had a discussion with my My case manager this morning about what they cover and what they don’t. She matter-of-factly stated “they won’t cover some incontinence supplies without prior approval, but I can go to mattress land, which is a local furniture store, and order you a brand new recliner with heat, massage, and lift, and they will approve those Lickity split with no problem!”  I said “you’re kidding me aren’t you?”  She says “heck no, I’m telling you the truth! “
 

so, because I’ve been having trouble with my legs in my current recliner, which is probably I would say 8 to 10 years old, I asked her for permission to order me one of these recliners: it will have heat, massage, and lift capacity. This will allow me to be able to be lifted to a standing position should I have trouble standing, and it will allow me to have heat and massage or just heat if that is necessary. 
 

I guess the company that makes these is the one that makes the Catnapper recliner: I decided that I was going to order a new chair because it is high time that I take care of myself, and ask for and receive as much help as I can get. It is time that I take care of myself, and not worry about what people think say or believe. I figure if I’m able to get a chair like this, it will be easier on my legs, my back, and everything else, and it will be nicer than this chair which feels like a piece of 2 x 4 covered in felt, when I raise up and have my feet up. My stepmom and my dad have had chairs of this quality before, and I know that this chair will last, because I will take good care of it.

what color did I get?:  I got the burgundy one! This thing is dark in color, and it’s perfect for what I need. Because of incontinence, I got the darkest color possible, and because of the fact that this is a nicer chair, I will stick an incontinence pad on my chair of a washable nature, and that way I will be able to keep the chair clean if I have an accident. Imagine my shock to learn that I can get them to cover this expense but I can’t get some incontinence supplies from them without a lot of preapproval. Apparently it is a simple as:  they get approval, call up, get a chair, and within a week or two they deliver it. If and when I get this chair I will be in heaven, and I am sure that those like @DailyDi Understand exactly what I am going through, because our backs are constantly in pain. When I have the actual heat or heat and massage on, it will help me to relax, and believe you me I have been doing a lot of work around here, and people would be proud of me for what I have been able to do. I just figured that everyone would be interested to find out what I found out today! I was floored I can get a brand new chair already preapproved to replace my aging recliner, and it is as simple as 123!

Brian

Edited February 7, 2022 by ~Brian~
Removed dupe paragraph

[DailyDi]

Nice! Enjoy the new recliner!

[FretaBWet]

Congrats on the chair Brian, I'm happy for you. Your quality of life should always be considered when looking at your needs.

Hugs,

Freta

[square_duck]

So it's basically a fancy catapult....??

 

[Spanky]

That's great 

[Cute_Kitten]

Congrats! Enjoy the recliner! Hope it helps you feel better! 

[Cruiser 03]

If this is coming from a DME supplier , when I bought mine also in burgundy king size , for $22 extra I got 4 color and fabric matched reusable incontinence pads for each chair , that was a fantastic deal and honestly nobody would notice they are there . You might check on the availability for yours.

[~Brian~]

On 2/9/2022 at 10:06 AM, Cute_Kitten said:

Congrats! Enjoy the recliner! Hope it helps you feel better! 

@Cute_Kitten

thank you, I think it will!  I got an even nicer piece of good news today – my case manager called me and told me that I had a choice of either getting my recliner next week, or tomorrow! I chose tomorrow between 12 and one. I’m really happy!?????

18 hours ago, Cruiser 03 said:

If this is coming from a DME supplier , when I bought mine also in burgundy king size , for $22 extra I got 4 color and fabric matched reusable incontinence pads for each chair , that was a fantastic deal and honestly nobody would notice they are there . You might check on the availability for yours.

@Cruiser 03

This chair will be coming directly from a furniture outlet in my local area. I am not sure whether incontinence pads can be ordered for this, but I definitely will be looking into it at some point. For the time being, I have the extra large 30 x 36 incontinence washable pads via NORTHSHORE CARE that I can use, and I will continue to use these. I got that vino red color, because I don’t want anything that causes an accident to be visible to those that are looking at the chair. With these washable pads, they should help me maintain the chair in good condition for a long time.

i’m not sure how old the one that I’m sitting in now is, but my stepfather gave it to me about 3 to 4 years ago, and I thought time it was used, and he told me that there was a couple of arm rest covers that go over the top. I have not gotten them, and I wouldn’t expect him to give me them, because this chair is older and it doesn’t bother me that much. I’m not sure how old this chair is but I would think it is at least 10 years old, because he used it for a few years before I did, and then my parents gave it to me. As I told cute kitten yesterday, I was lucky because I talked to my case manager, On a whim, and she told me how hard it would be for me to get certain incontinence supplies covered, but that she could usually get me a lift massage and heat chair “no questions asked“ preapproved, and there would not be any problem. I said “oh really, so that’s what we’re gonna do we’re going to replace this thing“. About an hour ago, I got a call from my case manager telling me that it could be delivered tomorrow if I wanted it. I told her “hell yeah bring it on“ so now I will have a brand new chair they will bring it in, set it up, and then get rid of my old one, so I won’t have to pay any recycling fees I’m pretty happy right now!

thank you for the information about incontinence pads for chairs like this – I will look into these!

Brian

[~Brian~]

My new cat napper Recliner chair in burgundy is in position. This morning, I cleaned out in front of my entertainment system in my bedroom, cleaned behind the old chair, and then took the old chair out of position and swept up a ton of dirt and other things that fall on the floor when you were sitting in such a chair. I took a hand broom and swept the entire floor under it, and then after I got done with that noticed that there was a lot of dirt that was on the floor that I wanted to clean.

so then, Out came the mop bucket, and both of my mops:  I used the sponge mop to try to get as much grime and junk off the floor as possible. Because I did not want to wet the entire floor down all the way, I found it easier to take the bucket and dump some of the liquid from it right on to where it was the dirtiest, and then once I got that done I ended up using my sponge mop to mop up the dirt and everything else. Then used my string mop to catch the remainder and pick up anything that was remaining on the floor with my hands and stuck it inside the bucket and rinsed off of my mops replacing them back in the shower bay.

I used the sponge mop to try to get as much grime and junk off the floor as possible. Because I did not want to wet the entire floor down all the way, I found it easier to take the bucket and dump some of the liquid from it right onto where it was the dirtiest, and then once I got that done I ended up using my sponge mop to mop up the dirt and everything else. I then used my string mop to catch the remainder and pick up anything that was remaining on the floor with my hands and stuck it inside the bucket and rinsed off of my mops replacing them back in the shower bay.

then my Doorbell rang, and two gentleman from mattress land came  to my door with my brand new chair. The chairs come in two pieces the bottom, in the back. They ended up taking my old chair out first because I had it out in the middle of the floor. Once they ended up getting that out of here, it was pretty easy to put my new chair in the position. I gave him the option of taking and moving my old chair first, but they decided they wanted to put my new chair in the position. When I cleaned the floor I also made sure that all of my power strips cords and switches were actually easy To access, and that I could usually get to them. I had the installer what the chair directly into an always on switch in the strip that was on the floor, and now I have heat massage and lift Capacity with this chair.

so they plug me in, and then they took my old chair and took a cart and removed it. Cost my home health agency $30 to remove the old chair, and I’m so glad that they were able to take care of it, because it probably would’ve cost me $40 to have it removed if Barre Housing ended up removing it and charging me that fee. The chair cost about $1200, so this is one of the best chairs I’ve ever had in my life and I’m not joking. I have had recliners and other pieces of furniture since I moved out when I was 23, but this is the best piece of furniture I’ve ever owned second only to my full-size bed. I was Even able to have the chair placed in such a way so that I can fully reclined the chair to its full maximum position without too much trouble.

So, before I even sat down in the chair, I put my orangutan Amy in there. Then, I ended up sitting in the chair, and I called my case manager and told her that I was so happy with my new chair. It is my favorite color, and this is one thing that I really will take especially good care of, because my back and my body are important to me, and so is my health.

I guess what I heard from the other people in the urgency, was that they only have like 25 staffers available to assist people in the agency that are under their caseloads. This is because of COVID-19 and because of lack of staffing. For now, I only have the cleaning person coming in every other Wednesday, and the other person that comes in Monday and Thursday has been put on hiatus until such time as they have enough people to cover that extra service. I don’t mind this, because I know that some people get sick, or things happen. One of the things that I did not expect, was but the guy I was working with, got a new job between the time that I saw him on Monday and Thursday of this week. When I called my case manager on a whim that Thursday, I was told by the scheduler that they had to cut back my hours because of lack of staffing.  I don’t mind this, because I know there are certain individuals that need more assistance than I do, and I need to be able to prioritize the people that need more than I do.

as I said, I am a happy man! Very few things in my life make me feel as relaxed as this does. I can now fully recline turn on my end massage, and just close my eyes and let my body totally go. Think of it as you were on a tropical island in your paradise, everything is right, you feel like 1 million bucks, and then you have a dry diaper, and then you feel so good, that you fully relax, and when you are fully relaxed you release. The last time I felt this good for you when I was in Florida in 19 97 and 1999. When I had my vacation those two years, I had a friend of mine who was very well-versed in massage. She started at the Tip tip top of my head, and then went all the way down my body from head to toe. Let me tell you, there are very few times that I feel this way, but she had me totally sleeping, and I was so comfortable that I was drooling on the floor! When I sat in my chair for the first time and told my case manager how happy I was, I was euphoric, because I knew that I had something that I wanted, it will work for me, I am comfortable, and my legs do not hurt when they are in this chair.  
 

@Cruiser 03 I ended up measuring the seat of my new chair, and I had to downsize the washable cushion that I stick on it. This is because I cannot wrap the entire cushion all the way around the padding, so I went from a extra large two large and covered the entire seat. What I do is, I change the pod when I noticed that it needs to be changed, and I change it to a clean one. Because I use the extra larges on my older chair, I had to go to my box and get the smaller version of the same pad. What will you, these type of incontinence supplies have already been approved by my agency, so if I need any of these I can get these reordered. Yesterday I got an order of my 1000 count  disposal bags from NORTHSHORE CARE, and the other day I got my order of extra large wipes from NORTHSHORE CARE. Right now, I think I have everything I need, and I was pleasantly surprised as I stated above that I was able to get my chair almost right away. The reason is is because my case manager went out of her way to make sure I had my chair as fast as possible. When you have a case manager like this, you don’t wanna let her go, and she has been doing so much for me that I I feel so good inside, and today when I called her I thanked her for everything that she does for me, And all of the things that they have done for me in the past because without them I would be a nervous wreck and I probably would be worse off than I am now. Thank God for the fact that they understand my incontinence and other issues, and are there to help me as much as they can!

right now I’m in my chair, fully reclined to the max, and I’m so comfortable that it’s incredible! I don’t know how else to say this, but I am in heaven right now: now, if only @Evelyn Dellcerro@Transfusionelle@philmydiaperand @amorfraldaJRCould see me now! I feel like a king and after a while I will get used to this! I feel as if one of my dream has come true, I’ve always wanted a new recliner, but I could never afford the cost: thank God for home health agencies and for the people who work so hard to keep us disabled people upright.

Brlan
 

 

Edited February 11, 2022 by ~Brian~
Added additional information and corrected usage in spots

[Little BabyDoll Christine]

It might be that wipes and sprays are Over-the-Counter. My insurance has a card for that called an "OTC card"

A few years ago, almost as a joike about IC, I asked if my insurance covers cloth diapers and rubber pants and I found out they do. So you might say, in modern terms, that my insurance covers covers