The Colon Club

Any advice for us? Husband was laid off as business project manager in company buyout and restructuring, went in for routine colonoscopy, diagnosed with cancer while laid off. Now we are looking at a full year of surgeries and chemo plan. Praise God he has COBRA.

Financial advice/hope. We have children in college too.

SilverWedding wrote:Any advice for us? Husband was laid off as business project manager in company buyout and restructuring, went in for routine colonoscopy, diagnosed with cancer while laid off. Now we are looking at a full year of surgeries and chemo plan. Praise God he has COBRA.

Financial advice/hope. We have children in college too.

You could start off by accessing the American Cancer Society website, which has a search facility for finding various organizations in your geographical area that deal with financial issues, insurance issues, and a number of other problems faced by cancer patients and their families:

Cancer support programs and services, by ZIP code
https://www.cancer.org/treatment/support-programs-and-services.html

Insurance shouldn’t be the issue. People complain about health insurance in the US (and there are issues), but as a cancer patient, I’ll take an Obamacare plan vs European/Canadian public insurance any day.

An ACA plan (Obamacare) may be more affordable than your employer’s COBRA especially if you're eligible for subsidies. ACA plans are good insurance, it will cover everything. The only downside is that the network is typically limited to your home state. I would pay extra for a PPO as a cancer patient - but it’s not necessary.

If it’s a stage IV diagnosis, he is automatically eligible for disability. After two years on disability he will be eligible for Medicare - which is slightly more affordable than an ACA plan and has a nationwide network if you opt for original Medicare.

As a Canadian I can’t complain about the level of care I’ve had here.

Serious illnesses are prioritized. I’ve waited 11 months for a CT scan for something not urgent, I’ve also been squeezed in immediately numerous times over the past 6 months for many procedures.

All without giant bills or premiums.

Your kids need to talk with financial aid counselors and rework their financial aid situation immediately before colleges finalize everything this summer. Have them do as much legwork for you as possible so you can manage corrections and oversight quicker, with less stress.

Their plans will likely change. Kids may decide to take jobs or even cancer related projects, investigate new options (for you or themselves), come home or be nearby for a semester or a year, to help however they can and to be with their dad.

Stage 4 CRC is a family financial and medical emergency. People often get abused or outlay too much cash early in the cancer voyage not questioning things; cash has to be carefully conserved and managed for a long haul with maximum benefit and new possibilities.

Pyro70 wrote:I
An ACA plan (Obamacare) may be more affordable than your employer’s COBRA especially if you're eligible for subsidies. ACA plans are good insurance, it will cover everything. The only downside is that the network is typically limited to your home state. I would pay extra for a PPO as a cancer patient - but it’s not necessary.
.

The down side to Obamacare, you can only be treated a a local hospital. If you are dealing with a stage IV cancer you really want to get treatment at a major cancer hospital. Even if you have a major cancer hospital in your town, they will not take Obamacare.

We have the Mayo Clinic and they will not take Obamacare here.

Personally I would keep Cobra, I believe you have more options with it.

Lee

Lee wrote:

Pyro70 wrote:I
An ACA plan (Obamacare) may be more affordable than your employer’s COBRA especially if you're eligible for subsidies. ACA plans are good insurance, it will cover everything. The only downside is that the network is typically limited to your home state. I would pay extra for a PPO as a cancer patient - but it’s not necessary.
.

The down side to Obamacare, you can only be treated a a local hospital. If you are dealing with a stage IV cancer you really want to get treatment at a major cancer hospital. Even if you have a major cancer hospital in your town, they will not take Obamacare.

We have the Mayo Clinic and they will not take Obamacare here.

Personally I would keep Cobra, I believe you have more options with it.

Lee

It’s a good point about the hospital network, but it depends on your ACA plan’s and employer’s network. BCBS of Michigan for example is accepted in essentially all major hospitals in Michigan. Many employer plans also have a restricted network - especially out of state. Some ACA plans (eg BCBS ppo) cover nationwide but you’re subject to a higher deductible and potentially “balance billing”. The network is the biggest issue for most insurances and you should ensure your hospital of choice is in your network with either an ACA or employer plan. If you can’t get to the hospital of your choice you can always “move” (and I’m putting that in quotes for a reason), and then purchase an ACA plan in your new local. If you “move” states you are eligible for special enrollment under ACA.

Pyro70 wrote:It’s a good point about the hospital network, but it depends on your ACA plan’s and employer’s network. BCBS of Michigan for example is accepted in essentially all major hospitals in Michigan. Many employer plans also have a restricted network - especially out of state. Some ACA plans (eg BCBS ppo) cover nationwide but you’re subject to a higher deductible and potentially “balance billing”. The network is the biggest issue for most insurances and you should ensure your hospital of choice is in your network with either an ACA or employer plan. If you can’t get to the hospital of your choice you can always “move” (and I’m putting that in quotes for a reason), and then purchase an ACA plan in your new local. If you “move” states you are eligible for special enrollment under ACA.

I will be the first to admit, I don't know a lot about Obamacare. We have a good medical plan through my husband's employer, but the cost have gone up. But I do know a few people who do not like it. Others seem to be happy with it. I have a good friend, she and I have had a few discussions about Obamacare prior to it's emplement. She voted for Obama the 2nd because of Obamacare. Her husband also has a good medical plan through his employer. She was going to vote for Hillary and has the bumper sticker to prove it. After Obama won the 2nd time they saw there premiums shoot up. Right before they were to vote in the 2016 election, there premiums skyrocketed. She voted for Trump because of Obamacare.

Sometimes moving is not really a option. I don't know how I would have got through chemo, surgery, etc without my family and friends. My network was a life saver more than once.

But I do understand what you are saying.

Lee

CF_69 wrote:As a Canadian I can’t complain about the level of care I’ve had here.

Serious illnesses are prioritized. I’ve waited 11 months for a CT scan for something not urgent, I’ve also been squeezed in immediately numerous times over the past 6 months for many procedures.

All without giant bills or premiums.

I agree 100%
I have read enough horror stories on this forum over the last five years regarding the American profit before patients mentality sweeping their healthcare system. Yes, we don't have the perfect system up here but nobody in Canada goes broke fighting cancer.

My biggest out of pocket expense was hospital parking.

I think the Affordable Care Act is a lifesaver and a godsend. It is especially critical for those of us with pre-existing conditions. Insurers wouldn't cover those of us with pre-existing conditions before the ACA. My husband and I are retired and purchase health insurance through healthcare.gov. We qualify for a subsidy for the time being and only have to pay $95/ month. At some point we will need to take money from our retirement accounts that will put our income over the limit and we will have to pay full price. Our deductibles are high but we have maxed out contributions to a health savings account for a number of years to cover those expenses. Prices actually came down this year for premiums and we had many more options to choose from and if the current administration would quit trying to dismantle the program with absolutely no alternatives, it would probably work better. The insurance companies are making money hand over fist, while we pay through the nose. The ACA is not perfect by a long shot but I am very thankful for it until they come up with something better. When people are ill and fighting for their lives they shouldn't have to stress out about the financial aspect of healthcare. Universal healthcare, please.

I am not far from the Mayo Clinic, but my policy doesn't cover Mayo. There was one plan available this year that did cover Mayo but I could only go to Mayo affiliated clinics so I didn't choose that coverage. I am NED but if that should change, I would change my insurance at open enrollment.

All that being said, I would probably keep my Cobra coverage. You have probably met deductibles. But I would check healthcare.gov and see what the options are in your area and check out the doctors, clinics, and hospitals in the networks.

Good luck and sorry for your husband's diagnosis. I am wishing you all the best. This forum is great and will help you through the months ahead.
Margie

We went thru the same thing. My husband was a pilot and federal aviation regulations do not allow a pilot to operate aircraft while undergoing chemo. He lost his medical and was played off till he finished treatment and could prove he was cancer free to the best of the doctors knowledge. We kept his medical insurance thru kobra. Our two sons were 12 and 13 years old at the time. Myself and the boys were able to go on Medicaid, while my husband kept his insurance thru kobra. He was treated at MDA and they would not take out of state medicaid or Obama care. I agree with Lee that you should try and keep the kobra.

I do hope things go well for you. Nothing like have stress on top of stress. Hang in there!

Ain’t that the truth.

It’s not all puppy dogs and ice cream up here either. In my province, if you’re gone for more 7 months of any 12 month period, you’re cut off. Due to the nature of my job, I was, so when I was diagnosed and sent home, I was not covered.

I did have insurance through my employer, but the system here is set up around the provincial health care.

So basically I had to pay for everything until I could establish residency. Thankfully my employer reimbursed me after much paper work, but there was always a chance they could deny me.

MRI’s, CT scans and radiation treatments aren’t cheap.

Another thing nobody considers is that your medications are not covered unless you have extra insurance or you qualify for some government program that I’m sure is not easy to get. My 5 cycles of Xeloda (generic) will cost me over $1200, and I know some medications are for more expensive than that.

Financial stress is definitely not something we need on top of battling this disease.

My life insurance policy has a critical illness and terminal illness rider. I was able to collect a portion for the critical illness, and the policy continues only the payout amount is then lowered by the amount i pulled out. It was quick and easy, had a check in two weeks

I agree with most of what was already said here. The ACA plan will be much cheaper if your income level allows for the subsidies. Many local hospitals are directly affiliated with the large hospitals on the northern east coast in Boston, NYC and Baltimore. I am not certain where you live though.

Excellent advice for immediately contacting your kids' financial aid offices before financial aid letters are sent out; and maybe adjusting a semester or two closer to home in a Community College, if they are still in their first or second year. They can save money this way.

Another overlooked benefit in State schools is that National Guard service covers 100% tuition and fees, while providing a skill / trade along with a good monthly income and summer employment. Most careers are represented in the NG and may help the kids to be proactive in their own care. Sometimes kids can get cheaper healthcare coverage through their schools too. It is worth the look, especially if you are buying COBRA coverage.

Above, it was also mentioned about Social Security Disability. You can find it by Googling "Social Security Compassionate Care." I think it is listed under "GI cancers" as being covered. It takes a stage IV diagnosis, and some time to get to Medicare coverage, but worth the review if you are qualified. Know the rules and apply if appropriate. Each State also has Medicaid programs that are income tested and are worth a review. A combination of these things may be a better decision than just a family COBRA policy.

This is a life changing event for the entire family, but one where safety nets are in place if you are proactive and seek them out. Keep a notebook of contacts and deadlines along with your medical records documenting the proper diagnosis and dates for job loss. You will use these dates on many forms and you want them to be consistent. Do not pay full price for anything and always question billing and potential discounts based on your change of income. They will not know these things unless you tell them. Lastly, most hospitals have oncology nurses who are patient advocates. Seek them out for help and direction. Keep good records, so that you can provide documentation and support to your claims.

Good luck in your process moving forward. There are may here who can keep you on track when questions arise.
Best wises,
WS

muskokamike wrote:

CF_69 wrote:As a Canadian I can’t complain about the level of care I’ve had here.

Serious illnesses are prioritized. I’ve waited 11 months for a CT scan for something not urgent, I’ve also been squeezed in immediately numerous times over the past 6 months for many procedures.

All without giant bills or premiums.

I agree 100%
I have read enough horror stories on this forum over the last five years regarding the American profit before patients mentality sweeping their healthcare system. Yes, we don't have the perfect system up here but nobody in Canada goes broke fighting cancer.

My biggest out of pocket expense was hospital parking.

But few, if any, Canadian provinces cover immunotherapy, at least that’s my understanding? Covering that 100k bill would cause many to go broke. The English system doesn’t cover Avastin because it’s not worth the cost / benefit. I don’t care about the cost, I want the drug if it helps and is tolerable. Many brits end up paying extensively for that drug.

I don’t want to start a debate, but i think it’s helpful for US patients to know ACA is actually a great safety net for catastrophic care. Yeah you’ll have to pay premiums and deductible. That will only cost around $12k per year. Sure that may be a lot of money, but really it’s nothing compared to lost wages from cancer. In exchange for those $12k you get access to any approved therapies, limited wait times compared to other health systems and access to top oncologists. Yes there is the issue with being out of network. But really it can be managed. I paid around ~12k under ACA and got access to everything. Insurance racked up a $500k+ bill with all my surgeries. I call that a good deal. Now for normal people (without high medical bills) ACA is not such a great plan. But better than nothing