My spouse was laid off with our health insurance ended immediately. I have stage 4 cancer, so I suspect that played a part in his lay-off and the immediately ended insurance benefits. Thoughts?
There is no way in he%* we can afford COBRA.
13 replies (most recent on top)
I decided to do Cobra after my husband died. I too had been diagnosed with cancer in that same year prior to going on Cobra. I knew the benefits my insurance would cover and also that I would not need to change doctors by continuing with my insurance plan under Cobra. This was a time when I did not want or need further disruptions. It's possible I could have saved a couple hundred a month, but by keeping my insurance at that difficult time, I was also buying peace of mind. After saying the above it is at this time of year that many employee plans enter open enrollment and if that's the case, you will want to be cognizant of any changes your employer is making regarding insurance benefits and/or insurance plans. If your employer will be changing insurance companies, or the plan changes significantly then it is worth your while to compare plans with the open market. And if you have to do that, be aware that an insurance plan from the same company your current plan is with does not guarantee that the new plan you will be buying (even if it is with the same company) will offer similar things. That same insurance company might not cover the doctor you go to. Medications and lab tests, etc, might be more costly. After my cobra ran out, I did have to go on the open market for an ACA plan. I went to an insurance broker, I told him what meds I was taking, and what doctors I went to. He was able to help me define more narrowly what I was looking for. Another thing to consider that many people aren't aware of is how medications are covered. And then they are surprised when they go to the pharmacy the first time they buy the same medication under their new policy. Look to see how your expected costs for medications will be. Will you pay a dollar amount or a percentage of the medication cost? Often insurance plans break medications down in tiers. Formulary tiers divide medications by costs. Tier 1 d--gs are generally cheaper than Tier 4 d--gs (generic vs preferred, off patent vs on patent). Anyway, some insurance plans have you cover a dollar amount of the cost, and some have you cover a percentage of the cost. It's often better to pay a dollar amount per month ($5.00 to $35.00 per month) then a percentage of the cost (say 30% of the cost per month) $5.00 to $35.00 per month is a heck of a lot cheaper than 30% of the cost, especially if the cost of the medication is 1500.00 per month. So if you find a policy with a lower premium, you also want to know what your true out of pocket expenses will be. Often a lower premium policy turns out to be more costly than a policy with a higher premium. That's why a lot of people who have traditional Medicare choose plan F (or G) as their Medigap policy.
Whoever said you lose insurance for 1 day they are WRONG. If you take COBRA it is retro'd. ACA also doesnt yet differ for pre-existing so the person whos said no one else will is also WRONG
OP: Sorry to hear about your situation.
I too have stage IV. Here are some acquired hints. As it turns out, COBRA for me was cheaper than ACA. The trick is that you need to get other insurance after 12 months because splitting the 6 months on one insurance and 6 months on another insurance means your deductible starts over.
Give the american cancer society a call. They will help you find services to help with financial burden. https://www.cancer.org/treatment/finding-and-paying-for-treatment.html .
Do an HSA high deductible plan. Once you reach your deductible it max's out expenses. You arent paying copays, like $250 for hospitialzations, $50 for your onco (specialists). The money you save on premiums ($800/mth) was remarkable. My home hospital charges 0% interest and will take some incredibly low minimum payment amount. When you do get bills, call them up before you pay. They all negotiate ! The year of 'gold plan' my out of pocket + premiums $36K. This year it will be around $27K if we max out deductible but it doesnt look like i will. (ACA HMO Bronze Saver HSA)
Keep paying life insurance, hopefully you have some for you which could let your wife recover the house. You get to continue the company life insurance, as self pay.
You will have an opportunity to switch health carriers/plan with the switch to COBRA. All insurance companies do their own negotiating with hospitals. For example, BCBS negotiates my quarterly CT down to $277 with my hospital while CIGNA did it at the same hospital for > $1,000. This means that while paying my deductible it stayed manageable.
YOU CAN AFFORD COBRA !!!!!! Trust when I say I never thought I could but did ! CALL BEFORE PAYING ANY AND ALL MEDICAL EXPENSES.
Seriously? Just shows how screwed up the American health system is. Meanwhile in Australia none of this crap occurs.
Borrow money if you have to and buy Cobra.
Regarding “I don't think it is fair that my spouse should lose the house and end up penniless after years of hard work.”
I fully agree. It is not fair that you have cancer, it is not fair that this will financially break your spouse, it is not fair that the insurance companies take advantage of you.
But this is the reality we all have to live with. I am sorry you are in a position to have to choose between housing and health care.
@anonymous who shared the link, thank you. Yes, our coverage has declined more every year. First through HP, and next through this company. We are still paying on my deductible for surgery.
@Anonymous (the super optimistic one). I have been in a clinical trial, paid for by my insurance, and it is stable. Being denied access to the trial is most likely a matter of life or death. We can afford COBRA or our house payment. I know the end game of cancer is death, but I don't think it is fair that my spouse should lose the house and end up penniless after years of hard work.
@trumphater - My spouse was terminated mid month.
You are normally paid up though the end of month, where and when did this happen?
1 year ago by Anonymous | Post ID: @MzxMAFK
3991 views | 14 replies (last 1 year ago
Buy the COBRA, please.
Yes, you are off insurance a day after separation.
With stage four cancer you’re not going to need health insurance much longer. Bite the bullet and buy COBRA for the short term. No one else will cover you.