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Doug in Portland

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      Doug in Portland
      Participant

        Michelle,

        I have been working my way through this over the past year. I have stage IV melanoma and stopped working after my last surgery. Anyway, I'll tell you what I can. My experience was with a large, publicly held company. There may be different rules for smaller, privately owned organizations but I think most of this still applies. Your best resource will probably be the social worker at your cancer center or hospital.

        1) Don should qualify for Social Security. Get the social worker to help fill out the forms or advise you. Make SURE you check to see if he has any short or long term disability through work. Often, these will provide 50% or more of his income and it will be partially or totally tax free. Short term will cover for the first 6 months and long term will take over after that. If he has short term disability, he will probably want to get off of the FMLA so he can get paid. With regard to long term, the insurance company will have a ton of paperwork but if SS is approved, they will probably approve as well. Stay proactive, they will drag their feet, lose your paperwork, etc. but in the end it will be worth the effort. Keep in mind you will still need to file for SS even if he has private coverage because insurance companies require it and also because he will need to be on SS to qualify for Medicare.

        2) Medicare will kick in 24 months from the date of his disability  (5 months after his date of eligibility or 29 months from the last day worked.

        3) COBRA coverage can be continued for just 1 person. We dropped my wife's coverage but have continued mine. Also, my wife has her own medical but no dental or vision so we continued those benefits for her and just cancelled the medical. Normally COBRA only continues for 18 months but it will continue for up to 29 months as long as the reason for employment termination is disability so there will be no lapse in coverage. Some HR people don't know this. MAKE SURE the official reason for resigning is DISABLED or ILLNESS and follow up with the administrator directly to confirm continuation of COBRA benefits. COBRA coverage will probably cost more because you will have to pay the employer's portion of the premium as well as the individual portion. With a family this could be significant. Your HR person can tell you how much. As for your employer's insurance, this should be a "qualifying event" and you should be able to pick up the family on your coverage without any medical questions however I don't know the rules on preexisting conditions.

        4) I don't know about state insurance but if all else fails, there is a high-risk insurance pool available. You will have to do some research but I am sure he would qualify. Now, there is usually a requirement that the person can't have had any insurance coverage for 6 months but I recently heard this requirement can be waived for some cancer patients. I doubt this is available as an alternative to COBRA.

        5) LIFE INSURANCE-If he has employer provided life insurance, don't let it lapse. The group life insurance provided by employers can be converted to a private policy but you have to ask HR for the forms and it will probably be expensive because the employer's group policy is TERM and the conversion policy will be WHOLE LIFE. In my case I also have to pay the premiums on an annual basis; monthly was not an option. That said, you are right, there really is no alternative.

        6) This is income-dependent. You can find info on the SS website.

        7) I struggled with this question, too but most HR professionals will help you and act as your advocate as long as you are an employee. Once employment is terminated, you will pretty much be on your own.

        This process can be stressful particularly when you are going through the trials of this disease but there are resources available and it's worth the effort. My thoughts and prayers are with you and your family.

         

        Doug in Portland
        Participant

          Michelle,

          I have been working my way through this over the past year. I have stage IV melanoma and stopped working after my last surgery. Anyway, I'll tell you what I can. My experience was with a large, publicly held company. There may be different rules for smaller, privately owned organizations but I think most of this still applies. Your best resource will probably be the social worker at your cancer center or hospital.

          1) Don should qualify for Social Security. Get the social worker to help fill out the forms or advise you. Make SURE you check to see if he has any short or long term disability through work. Often, these will provide 50% or more of his income and it will be partially or totally tax free. Short term will cover for the first 6 months and long term will take over after that. If he has short term disability, he will probably want to get off of the FMLA so he can get paid. With regard to long term, the insurance company will have a ton of paperwork but if SS is approved, they will probably approve as well. Stay proactive, they will drag their feet, lose your paperwork, etc. but in the end it will be worth the effort. Keep in mind you will still need to file for SS even if he has private coverage because insurance companies require it and also because he will need to be on SS to qualify for Medicare.

          2) Medicare will kick in 24 months from the date of his disability  (5 months after his date of eligibility or 29 months from the last day worked.

          3) COBRA coverage can be continued for just 1 person. We dropped my wife's coverage but have continued mine. Also, my wife has her own medical but no dental or vision so we continued those benefits for her and just cancelled the medical. Normally COBRA only continues for 18 months but it will continue for up to 29 months as long as the reason for employment termination is disability so there will be no lapse in coverage. Some HR people don't know this. MAKE SURE the official reason for resigning is DISABLED or ILLNESS and follow up with the administrator directly to confirm continuation of COBRA benefits. COBRA coverage will probably cost more because you will have to pay the employer's portion of the premium as well as the individual portion. With a family this could be significant. Your HR person can tell you how much. As for your employer's insurance, this should be a "qualifying event" and you should be able to pick up the family on your coverage without any medical questions however I don't know the rules on preexisting conditions.

          4) I don't know about state insurance but if all else fails, there is a high-risk insurance pool available. You will have to do some research but I am sure he would qualify. Now, there is usually a requirement that the person can't have had any insurance coverage for 6 months but I recently heard this requirement can be waived for some cancer patients. I doubt this is available as an alternative to COBRA.

          5) LIFE INSURANCE-If he has employer provided life insurance, don't let it lapse. The group life insurance provided by employers can be converted to a private policy but you have to ask HR for the forms and it will probably be expensive because the employer's group policy is TERM and the conversion policy will be WHOLE LIFE. In my case I also have to pay the premiums on an annual basis; monthly was not an option. That said, you are right, there really is no alternative.

          6) This is income-dependent. You can find info on the SS website.

          7) I struggled with this question, too but most HR professionals will help you and act as your advocate as long as you are an employee. Once employment is terminated, you will pretty much be on your own.

          This process can be stressful particularly when you are going through the trials of this disease but there are resources available and it's worth the effort. My thoughts and prayers are with you and your family.

           

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