Major cancer centers/insurance

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WarriorSpouse
Posts: 148
Joined: Tue Aug 16, 2016 9:02 pm

Re: Major cancer centers/insurance

Postby WarriorSpouse » Sat Oct 27, 2018 1:20 pm

I thought I posted something on this earlier but it did not upload. Here is some information in Social Security Disability for those who can handle the reduction in work income, be able to afford Part B premiums, and can get decent supplemental coverage through a spouse or Obamacare. You must be diagnosed with Stage IV to qualify for SSDI / Medicare.

https://secure.ssa.gov/poms.nsf/lnx/0423022215

Another thing I would suggest is for people taking a job at a local school or hospital that offers better HC options. The jobs may be service related like food services, custodial or security, but the hours may be easy for the benefit gained in the better healthcare options they provide. If you work at a local private college you may get tuition benefits as well...Just some suggestions.

Good luck to all.
WS
Spouse of wife 47 years old
10/2014, Stage IV Metastatic CC
Lymph node involvement 12/15, w/ positive PET on para-aortic lymph nodes.
5 cm sigmoid tumor resection as well as positive Virchow lymph node.
KRAS mut, Highly Differentiated, Lynch Negative
Folfox and Avastin 1 YR (Oxi for 5 months) NED 05/2015
Zeloda and Avastin since 01/2016
Chemo break 03/2017, back on Zeloda and Avastin 04/2017.

"...Perseverance is not a long race; it is many short races one after the other."
-Walter Elliot

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peanut_8
Posts: 2287
Joined: Sun May 25, 2014 1:31 pm
Location: Capital of Texas

Re: Major cancer centers/insurance

Postby peanut_8 » Sat Oct 27, 2018 2:07 pm

margiej wrote:The LLC option is very interesting. We will look into it. Did you create a business, Peanut? I think our business would show nothing but losses if we were paying for health insurance. And I have definitely heard that about Starbucks, Jannine. Might be a viable option, too. My husband and I are both 60... Hoping for some kind of early buy-in for Medicare at some point! Even though the health insurance is problematic, we are getting by.
Margie


Yes, our LLC is a business of sorts. At this point is is just a holding company for an investment that we own. I doubt that our income will equal our expenses, butt it is just for a few years until we hit official retirement age. It does require more paperwork, butt since we're retired we have time for that.

I should add that we went through a local insurance broker, who advised us to form the LLC. We ran the idea past our attorney who gave us the go-ahead. Kind of a pain in the ass, butt we did get to choose a very nice plan.
Terri aka peanut
diagnosed Jan 14, RC stage 2a, age 56
permanent colostomy
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

Jannine
Posts: 74
Joined: Wed Jun 20, 2018 7:46 am

Re: Major cancer centers/insurance

Postby Jannine » Sat Oct 27, 2018 3:51 pm

WarriorSpouse wrote:Another thing I would suggest is for people taking a job at a local school or hospital that offers better HC options. The jobs may be service related like food services, custodial or security, but the hours may be easy for the benefit gained in the better healthcare options they provide. If you work at a local private college you may get tuition benefits as well...Just some suggestions.

Good luck to all.
WS


Public colleges and universities, including community colleges, also generally provide tuition benefits. At a 2-year institution this may cover a 2-year associate's degree at the same institution for self and children and maybe spouse. A 4-year non-graduate college will provide tuition for an undergraduate degree for the same. Universities that offer advanced degrees will generally cover tuition for master's degrees at least, but that may only extend to self; not sure. Fees won't be covered, nor will textbooks, which do add up. So it is not free, but it is generally a BIG cost savings all the same.

Private schools may offer employee tuition benefits that cover attendance at other schools as well. You would have to check with the specific institution to find out their policies, though.

These programs won't necessarily cover full time school for employees; there's usually a per-semester or per-year limit on tuition benefits, at least in the US. I don't know if that is a limitation for children of employees though.

As one example, our campus police force at my college is mostly retired police officers who want to provide a good education for their kids when they get to be college age.
DX: sigmoid colon cancer 5/2018. 48 F
laparoscopic sigmoid resection (24 cm removed); no stoma.
7.5cm adenocarcinoma -- mod diff.
1 noncontiguous tumor deposit also removed; 0/31 lymph nodes
T3 pN1c M0
5/2018 before surgery, CEA 11.2
6/2018 began 12 infusions adjuvant FOLFOX; CEA 3.7
7/2018: CEA 1.9; added neulasta post infusion
9/2018: CEA 2.8
10/2018: CEA 2.4

WarriorSpouse
Posts: 148
Joined: Tue Aug 16, 2016 9:02 pm

Re: Major cancer centers/insurance

Postby WarriorSpouse » Sun Oct 28, 2018 9:55 am

My original point with such employment options are that schools and hospitals usually have excellent flexible hours and excellent healthcare policies in place for those needing reliable coverage options. You can work weekends or evenings and have fulltime coverage, while allowing free daytime hours for medical appointments, household errands, and even a peaceful nap.

Anyone looking for better healthcare coverage should take a look, especially if you have a well funded retirement account or are already done with your initial career.

Best wishes,
WS
Spouse of wife 47 years old
10/2014, Stage IV Metastatic CC
Lymph node involvement 12/15, w/ positive PET on para-aortic lymph nodes.
5 cm sigmoid tumor resection as well as positive Virchow lymph node.
KRAS mut, Highly Differentiated, Lynch Negative
Folfox and Avastin 1 YR (Oxi for 5 months) NED 05/2015
Zeloda and Avastin since 01/2016
Chemo break 03/2017, back on Zeloda and Avastin 04/2017.

"...Perseverance is not a long race; it is many short races one after the other."
-Walter Elliot

NHMike
Posts: 1795
Joined: Fri Jul 21, 2017 3:43 am

Re: Major cancer centers/insurance

Postby NHMike » Mon Oct 29, 2018 8:25 am

I did my Open Enrollment this morning and found that I had already signed up for 66 2/3rds after-tax Long-Term Disability. I must have done this last year during Open Enrollment. I don't recall doing this but I was thinking more about life insurance and maybe I changed both and unchanged life insurance after re-considering. So I guess I could do LTD but I don't have any current plans to do so as I am moderately functional and hope to get better.

Life insurance is another consideration. I have five times salary after-tax. We can do a maximum of seven times salary after tax and more before tax. I think that our assets are sufficient so that my wife would be fine if I died but life insurance is pretty cheap at my company. I have another two weeks to think about it if I change my mind.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

martd
Posts: 54
Joined: Tue Nov 21, 2017 3:48 pm

Re: Major cancer centers/insurance

Postby martd » Mon Oct 29, 2018 10:11 am

NHMike wrote:I did my Open Enrollment this morning and found that I had already signed up for 66 2/3rds after-tax Long-Term Disability. I must have done this last year during Open Enrollment. I don't recall doing this but I was thinking more about life insurance and maybe I changed both and unchanged life insurance after re-considering. So I guess I could do LTD but I don't have any current plans to do so as I am moderately functional and hope to get better.

Life insurance is another consideration. I have five times salary after-tax. We can do a maximum of seven times salary after tax and more before tax. I think that our assets are sufficient so that my wife would be fine if I died but life insurance is pretty cheap at my company. I have another two weeks to think about it if I change my mind.
. Also with life insurance look into critical illness rider and terminal illness rider. I was able to to collect on a critical illness rider on my policy, I didn't even know it was there until I had a conversation with my insurance agent.
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT
12 rounds folfox , avastin / oxi
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7

NHMike
Posts: 1795
Joined: Fri Jul 21, 2017 3:43 am

Re: Major cancer centers/insurance

Postby NHMike » Mon Oct 29, 2018 10:28 am

martd wrote:
NHMike wrote:I did my Open Enrollment this morning and found that I had already signed up for 66 2/3rds after-tax Long-Term Disability. I must have done this last year during Open Enrollment. I don't recall doing this but I was thinking more about life insurance and maybe I changed both and unchanged life insurance after re-considering. So I guess I could do LTD but I don't have any current plans to do so as I am moderately functional and hope to get better.

Life insurance is another consideration. I have five times salary after-tax. We can do a maximum of seven times salary after tax and more before tax. I think that our assets are sufficient so that my wife would be fine if I died but life insurance is pretty cheap at my company. I have another two weeks to think about it if I change my mind.
. Also with life insurance look into critical illness rider and terminal illness rider. I was able to to collect on a critical illness rider on my policy, I didn't even know it was there until I had a conversation with my insurance agent.


I don't think that I have this as it's a company policy and most of our employees are younger so I wouldn't expect a lot of demand for something like this. This is all term insurance. I had a regular life insurance policy but dropped it in my late 40s as we had accumulated enough wealth not to really need a policy. The life insurance at work, though, is really cheap, likely because most workers are a lot younger - so I thought that the cost-benefit level was good.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

deebashari
Posts: 15
Joined: Wed Feb 07, 2018 2:51 am

Re: Major cancer centers/insurance

Postby deebashari » Mon Oct 29, 2018 9:49 pm

Hi hope you’re doing well. You hold a very dimilar profile to my mom, are you NED?

NHMike wrote:I looked into this earlier this year and I think that there's only one provider in my state and I couldn't determine whether or not they covered MGH or Dana Farber. I looked into the MA (neighboring state) options and there might be coverage but I couldn't be sure. We have the option of 3 years of COBRA if I went out on long-term disability (something that I am considering though not too seriously). But I'm going to up my LTD to 66% from 50% this enrollment season.

My manager is generally sympathetic having had lifetime GI issues.

Some friends in New York tell me that the cost of healthcare.gov insurance can run around $3,000/month. Insurance in my area would be about $2,500/month and the coverage isn't anywhere near as good as our company insurance. So coverage is definitely an issue for people below retirement age.

NHMike
Posts: 1795
Joined: Fri Jul 21, 2017 3:43 am

Re: Major cancer centers/insurance

Postby NHMike » Tue Oct 30, 2018 2:54 am

deebashari wrote:Hi hope you’re doing well. You hold a very dimilar profile to my mom, are you NED?
[/quote]

Technically, yes. But it has been pretty challenging after the reversal.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

LindaG
Posts: 2
Joined: Sat Oct 06, 2018 12:42 pm

Re: Major cancer centers/insurance

Postby LindaG » Wed Oct 31, 2018 5:58 pm

I have gone without health insurance for several years all the while hoping I wouldn't have any major medication issues. Then last summer I get diagnosed with colon cancer and bladder cancer. It has been a heck of a ride since July, but things are starting to slow down and we are getting a breather ... No. Not really. The bills are starting to come in. There are hospital bills, physicians bills, lab bills, bills for scans (CT, PET, MRI). Prior to surgery, I asked about discounts for a cash pay patient and managed to get either Medicare rates, cash pay rates, or hospital discounts for most of them. It's a great day when mail-lady doesn't deliver a bill.

FWIW, My surgeon estimated the cost of surgery and treatment would be around $40k US.

I'll be signing up for obamacare for 2019. There's only one plan where I live and I have verified that all my doctors, clinics, and hospital are in-network (yeah!). I hope the insurance helps with the bills next year.
Dx: Colon Cancer (pT4bN0) so Stage 2B 7/2018
Dx: Bladder Cancer 8/2018
Surgery for both 8/2018
Temporary Ileostomy 8/2018
Bladder catheter 8/2018, removed 9/2018

JulesW
Posts: 9
Joined: Thu Jun 21, 2018 1:48 pm

Re: Major cancer centers/insurance

Postby JulesW » Sat Nov 03, 2018 10:30 am

peanut_8 wrote:Just my opinion, but health insurance options for early retirees suck. DH retired a couple years ago, and went on COBRA which lasted for 18 months. 36 months is not guaranteed, butt may be an option in certain specific situations. Obamacare options didn't really work for us, since we spend time in more than one state.

The solution we settled on was to start a LLC. The LLC then become eligible to acquire insurance from providers like BCBS and United Health Care. I realize that this solution won't work for everyone, butt highlights the lengths people have to go to for adequate insurance.

Best Wishes,
peanut


Hi Peanut,
I'm new to this board I have been following it for some time. I'm actually in Germany right now getting laser assisted pulmonary metastectomy. I just had a telephone meeting with my health insurance broker who said that none of the Obama care plans offer second opinions at major cancer centers. I asked her about the LLC option because I already have an LLC and am self-employed she said that I would need W-2 employees to qualify. How long did it take your LLC to become eligible to acquire insurance from providers like BCBS and United Healthcare? I definitely want to get follow up at a major cancer center.
Best,
JulesW

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peanut_8
Posts: 2287
Joined: Sun May 25, 2014 1:31 pm
Location: Capital of Texas

Re: Major cancer centers/insurance

Postby peanut_8 » Sat Nov 03, 2018 4:10 pm

Hi Peanut,
I'm new to this board I have been following it for some time. I'm actually in Germany right now getting laser assisted pulmonary metastectomy. I just had a telephone meeting with my health insurance broker who said that none of the Obama care plans offer second opinions at major cancer centers. I asked her about the LLC option because I already have an LLC and am self-employed she said that I would need W-2 employees to qualify. How long did it take your LLC to become eligible to acquire insurance from providers like BCBS and United Healthcare? I definitely want to get follow up at a major cancer center.
Best,
JulesW[/quote]



Welcome to Colon Talk Jules,

The process went pretty quickly, only a couple of weeks. We had our lawyer assist with forming the LLC. We'd had one for a previous business, so were familiar with how they work. Once it was official, the insurance activated pretty much immediately. We do have W-2 employees, butt I'm not sure if that is a requirement everywhere.

Best Wishes,
peanut
Terri aka peanut
diagnosed Jan 14, RC stage 2a, age 56
permanent colostomy
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED


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