Insurance(Cigna marketplace) won’t extend care for Grandma with Stroke
Need advice on situation with my grandma.
She had a stroke a month ago and had to do a Craniectomy to relive swelling in brain. Currently she's non verbal, and has no control on her right side, and on a peg tube. She moved to an LTAC and has been progressing decently and is not incubated any more(still has trach in place). Now that she's showing signs of progress, her insurance is saying she doesn't need anymore care from hospital and can go home. We were informed of this today and they want to discharge her by Tuesday. She is still unable to walk, talk, control her bladder or bowels and yet the insurance deems her medically stable enough to go home. We asked the Dr and social worker to appeal for an extension since as a family we don't have the tools and knowledge to fully take care of her, but they refused and say theres nothing they can do. We called Cigna and they say the faculty can request for an extension and appeal yet the social worker says thats not possible. The social worker said they'll provide equipment by Tuesday and she'll get some home health.
How is someone with a Craniectomy medically stable? Also we asked if we can get an option for skilled nursing facilities, yet she got rejected from 48 facilities, per the social worker. We asked for reasons but social worker won't give us the reasons and asked us to reach out ourselves to the facilities. We are overwhelmed and floored currently. Not sure what to do.
submitted by /u/halaMadrid101