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End of life - Cancer - Insurance

HawkeyeShawn

HawkeyeShawn

HR Heisman
Nov 9, 2001
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Sad post, but looking for anyone with experience in this.

My sister is 56 with stage 4 with pancreatic cancer. Was given 1-2 years this past Spring, with additional chemo treatments. She has pretty good insurance through a major company, Sprint/T-Mobile. She used up her disability benefits already. The company has been really good to her the past year during her fight. In order to keep her insurance and she was going a little stir crazy, she decided to go back to work on 10/1. Today she was told she now has months. Don’t know if that’s 1-2, 2-4 or 3-6, but we are seeing her decline rapidly.

Family wants her to quit her job and move over to COBRA for the remainder of her life. We can pay the premiums for her. We can pay for her living expenses over the next several months. I have no idea how COBRA works for a situation like this. Anyone ever been through this with a loved one?
 
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Not sure what you mean she used up her disability. Meaning she can’t go on short term or long term any longer? The company will keep her on insurance is my understanding, especially under a terminal diagnosis.
 
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HawkeyeShawn said:
Sad post, but looking for anyone with experience in this.

My sister is 56 with stage 4 with pancreatic cancer. Was given 1-2 years this past Spring, with additional chemo treatments. She has pretty good insurance through a major company, Sprint/T-Mobile. She used up her disability benefits already. The company has been really good to her the past year during her fight. In order to keep her insurance and she was going a little stir crazy, she decided to go back to work on 10/1. Today she was told she now has months. Don’t know if that’s 1-2, 2-4 or 3-6, but we are seeing her decline rapidly.

Family wants her to quit her job and move over to COBRA for the remainder of her life. We can pay the premiums for her. We can pay for her living expenses over the next several months. I have no idea how COBRA works for a situation like this. Anyone ever been through this with a loved one?
Click to expand...
I'm very sorry to hear this. I wish her and your family nothing but positive as she continues to battle.
 
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Cobra basically references your ability to maintain your employer based coverage (more or less) by paying the premiums yourself, after you leave employment for certain qualifying reasons. General info here:

www.dol.gov

Continuation of Health Coverage (COBRA)

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or...
www.dol.gov www.dol.gov

One question re: the disability reference. While she is not 65, in some cases medicare can kick in based on disability, and Medicare also provides a hospice benefit, basically for 6+6 months of end of life care with a terminal diagnosis. If you are resigned to the outcome and it is consistent with your beliefs, many patients and families get a lot out of hospice in their final months.
 
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I have a good friend going through the same. Turns out with a stage 4 terminal cancer diagnosis you can take out of your 401k and some insurance policies without penalty.

I'd suggest she speak to HR about their disability plan. My friend is on short term, gets 60% pay for a while, and then goes to long term (he won't make it that long). He still is considered an employee, gets health benefits and even accrues vacation time.
 
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Sorry to hear that. I know it depends on the employer but when my dad got diagnosed his company kept him on and he just had to pay his same portion of the premium out of pocket after all of pto ran out and he went on short and then long term disability. It was a blessing because they had a very low max out of pocket of like 8k and that was met in the diagnosis phase so all treatment and the hospice was taken care of.
I’d definitely be speaking with the benefits people at the company before terminating her employment. There might be life insurance that’s affected as well if she officially leaves the company.
 
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Aardvark86 said:
Cobra basically references your ability to maintain your employer based coverage (more or less) by paying the premiums yourself, after you leave employment for certain qualifying reasons. General info here:

www.dol.gov

Continuation of Health Coverage (COBRA)

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or...
www.dol.gov www.dol.gov

One question re: the disability reference. While she is not 65, in some cases medicare can kick in based on disability, and Medicare also provides a hospice benefit, basically for 6+6 months of end of life care with a terminal diagnosis. If you are resigned to the outcome and it is consistent with your beliefs, many patients and families get a lot out of hospice in their final months.
Click to expand...
I was going to suggest checking with the state for Medicaid/Medicare options.
 
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HawkeyeShawn said:
Sad post, but looking for anyone with experience in this.

My sister is 56 with stage 4 with pancreatic cancer. Was given 1-2 years this past Spring, with additional chemo treatments. She has pretty good insurance through a major company, Sprint/T-Mobile. She used up her disability benefits already. The company has been really good to her the past year during her fight. In order to keep her insurance and she was going a little stir crazy, she decided to go back to work on 10/1. Today she was told she now has months. Don’t know if that’s 1-2, 2-4 or 3-6, but we are seeing her decline rapidly.

Family wants her to quit her job and move over to COBRA for the remainder of her life. We can pay the premiums for her. We can pay for her living expenses over the next several months. I have no idea how COBRA works for a situation like this. Anyone ever been through this with a loved one?
Click to expand...

Sorry to hear about your sister. I'm guessing she's single or divorced or she'd be able to go on her husbands insurance. If so, I wouldn't worry about the cost of anything. I'm usually totally against people doing this but since she got such a bad deal (cancer at 56), I'd just start using her credit cards to pay for expenses. I wouldn't pay a dime towards any medical costs or credit cards at this point. Chances are nothing will have to be paid back. As someone has already said, the company HR department should be able to help with COBRA if needed.
 
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Cancer sucks! T's & P's. :mad:😞

With Cobra, you pay 100% of the cost plus 3% admin costs.

So, say it's a company policy and your sister pays $250/mo pretax. Her actual premium might be, say $500/mo and the company is picking up 1/2.

So, her insurance might be $515/mo in this example.

Remember, I am making up ALL of these numbers.
 
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IowaPackFan said:
Not sure what you mean she used up her disability. Meaning she can’t go on short term or long term any longer? The company will keep her on insurance is my understanding, especially under a terminal diagnosis.
Click to expand...
Correct. Short term and long term are exhausted.
 
Aardvark86 said:
Cobra basically references your ability to maintain your employer based coverage (more or less) by paying the premiums yourself, after you leave employment for certain qualifying reasons. General info here:

www.dol.gov

Continuation of Health Coverage (COBRA)

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or...
www.dol.gov www.dol.gov

One question re: the disability reference. While she is not 65, in some cases medicare can kick in based on disability, and Medicare also provides a hospice benefit, basically for 6+6 months of end of life care with a terminal diagnosis. If you are resigned to the outcome and it is consistent with your beliefs, many patients and families get a lot out of hospice in their final months.
Click to expand...
Appreciate this info.
 
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ICHawk-I said:
I have a good friend going through the same. Turns out with a stage 4 terminal cancer diagnosis you can take out of your 401k and some insurance policies without penalty.

I'd suggest she speak to HR about their disability plan. My friend is on short term, gets 60% pay for a while, and then goes to long term (he won't make it that long). He still is considered an employee, gets health benefits and even accrues vacation time.
Click to expand...
Her short term disability ran out 9/30.
 
jawatkins said:
Sorry to hear that. I know it depends on the employer but when my dad got diagnosed his company kept him on and he just had to pay his same portion of the premium out of pocket after all of pto ran out and he went on short and then long term disability. It was a blessing because they had a very low max out of pocket of like 8k and that was met in the diagnosis phase so all treatment and the hospice was taken care of.
I’d definitely be speaking with the benefits people at the company before terminating her employment. There might be life insurance that’s affected as well if she officially leaves the company.
Click to expand...
Yes, she’s stated she’s working to keep her health and life insurance.
 
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SB_SB said:
Sorry to hear about your sister. I'm guessing she's single or divorced or she'd be able to go on her husbands insurance. If so, I wouldn't worry about the cost of anything. I'm usually totally against people doing this but since she got such a bad deal (cancer at 56), I'd just start using her credit cards to pay for expenses. I wouldn't pay a dime towards any medical costs or credit cards at this point. Chances are nothing will have to be paid back. As someone has already said, the company HR department should be able to help with COBRA if needed.
Click to expand...
Married, but I don’t think her partner has any or decent insurance.
 
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The life insurance benefit is not something that falls under cobra. Is there any way she or someone can pay that premium and keep the policy if she leaves?
 
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Bank of Hawk said:
The life insurance benefit is not something that falls under cobra. Is there any way she or someone can pay that premium and keep the policy if she leaves?
Click to expand...
I think she’s hanging onto her job more for this benefit than anything else. I don’t believe he partner can make it on her own, without my sister’s income. So she wants to leave something behind for her.
 
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HawkeyeShawn said:
I think she’s hanging onto her job more for this benefit than anything else. I don’t believe he partner can make it on her own, without my sister’s income. So she wants to leave something behind for her.
Click to expand...

She definitely needs to check with her employer's HR department (or with the insurance company who handles the company's benefits plan). Group plans frequently include a "portability" clause that allows someone to convert the policy from the group plan into an individual plan without having to go through any type of physical or health examination. The cost would surely be higher than under the group plan, but in this circumstance the higher cost doesn't make much difference since it will be for a short time.

It's discussed in this article...

moneysmartlife.com

How to Convert Employer-Paid Insurance to an Individual Policy Upon Layoff

Will your employer-based insurance convert into an individual policy? How does the process work? Find out!
moneysmartlife.com
 
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HawkeyeShawn said:
I think she’s hanging onto her job more for this benefit than anything else. I don’t believe he partner can make it on her own, without my sister’s income. So she wants to leave something behind for her.
Click to expand...

If her life coverage is part of a group insurance, some employers allow a conversion of the life insurance when employment ends. I'm sure it's not all employers but I deal with several that do in my position.
 
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HawkeyeShawn said:
Correct. Short term and long term are exhausted.
Click to expand...
There must be something else. I’ve had a person out since December of 2021 (yes, 2021, not 2022) and he’s still under company insurance. I don't get too involved as he’s working with a third party who manages these sorts of things. However, our open enrollment for benefits is coming out soon and I noticed he’s still in our org (which I always knew), but eligible for benefits.
 
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So sorry to hear about your sister @HawkeyeShawn, that sucks. I lost a younger brother to cancer last October, he was 53 years old when he passed. Upon diagnosis he started treatments @ UIHC hoping for a miracle, but the only benefit really was it allowed him to hang on for about a year and he and his family made the most of it. It still hurts to think about it, I hope your sister is comfortable throughout this process, it takes a toll both mentally, physically, emotionally and spiritually. Support her in any way that you can and treasure the time that remains.
 
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Sorry to hear about this. Lost my Dad to cancer several years ago and dealt with him quitting his job once he was unable to work. He was old enough to qualify for Medicare so we did not have to deal with COBRA. There was a website referred to us called triagecancer.org that has a bunch of resources for insurance and legal issues that come up for people with cancer. There is a lot of checklists and other helpful resources available on the site.

Also, tell your sister not to lose hope. My Dad was told by his doctor he would be dead within a couple months but ended up living 2 more years. Cherish whatever time is left.
 
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IowaPackFan said:
There must be something else. I’ve had a person out since December of 2021 (yes, 2021, not 2022) and he’s still under company insurance. I don't get too involved as he’s working with a third party who manages these sorts of things. However, our open enrollment for benefits is coming out soon and I noticed he’s still in our org (which I always knew), but eligible for benefits.
Click to expand...
I agree. I’m think there’s more that can be done. I think she’s just a proud woman and doesn’t want to ask. Time put away that pride.
 
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@HawkeyeShawn , So very sorry for for you, your sister and your family. I hope things go as well as possible going forward.

I’d check with Social Security as soon as possible for disability insurance and benefit coverage. It may take a while, but they will also pay retro, I believe, to when she lost her insurance coverage, and long-term disability pay. Whatever insurance company was handling her long-term benefit coverage should have helped with that transfer process to SS, as I’d think she would definitely qualify.
 
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HawkeyeShawn said:
Sad post, but looking for anyone with experience in this.

My sister is 56 with stage 4 with pancreatic cancer. Was given 1-2 years this past Spring, with additional chemo treatments. She has pretty good insurance through a major company, Sprint/T-Mobile. She used up her disability benefits already. The company has been really good to her the past year during her fight. In order to keep her insurance and she was going a little stir crazy, she decided to go back to work on 10/1. Today she was told she now has months. Don’t know if that’s 1-2, 2-4 or 3-6, but we are seeing her decline rapidly.

Family wants her to quit her job and move over to COBRA for the remainder of her life. We can pay the premiums for her. We can pay for her living expenses over the next several months. I have no idea how COBRA works for a situation like this. Anyone ever been through this with a loved one?
Click to expand...
Pancreatic is one of the worst, lost a friend earlier this year to it. So sorry she and your family is going through this. Wish we had better options. Best of luck and hope it's as painless as possible for her.
 
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With my company, we have 6 months of short term and then switch to long term. My insurance is covered while I'm on short term, then after that I would need to pay for my own COBRA. Up until the last couple if years, if we went on long term, we were terminated. That has changed and depending on the situation we can now return to work months beyond that.

I'm sorry to hear about your sister. Cancer can be brutal, and it stretches well beyond the patient.
 
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