I am going to try & write this for a 3rd time. I start spilling my guts in a pretty quick fashion and then I am done and go to submit, the page has timed itself out. My fault, I will save it this time...
This is where my DH & I are at. Diagnosed in October 2012, was told he could no longer work or drive, the company he worked for offers a short-term disability for a 6 month period. The amount is based on a 40 hour work week x his base pay. The gross is 276.00 per week, then taxes are taken out, medical and in the end, the net amount ends up being $125.00 per week. This amount is suppose to pay rent, utilities, etc, etc...NOT. Gave up my place because I could not afford to maintain the rent and bills, signed up on many waiting lists for low income housing, luckily in January 2013 was approve for one, which we were lucky, the wait came be up to 2 years for that I am grateful but certainly a whole new lifestyle but I am not proud, one does what they have to do, thankfully, my DH's father is still living at 91 years young, the man is amazing, still works 3 X weekly, drives 2 hours to get to work, he is physically and mentally fit. And if it weren't for his kindness and love for his son, I am not sure where we would be at this point in our journey, he has been so thoughtful and helpful. It shouldn't have had to be this way, to become dependent on other's to pay our way! There is something really wrong with the systems now in place and road you have to take to get there!
Well my DH was approved SSDI and will receive it 6 months later...April 2013, however, effective April 4th, he & I will lose his healthcare insurance from his employer because the short term disability runs out and he will be let go from the company, medical layoff. SSDI does not offer individuals any insurance benefit till 2 years from the date you applied. So another hurdle to get over. We are both left out in the COLD, searching for medical insurance, I knew this was coming, no time to stop and grief what is happening to my DH, keeping it all to myself, very stressful. I contacted over a month ago and researched many private insurance providers and not one will take him on and all their questionaires ask if there is a pre-existing conditon. So I went to the state medicaid office and he was approved, but the letter they sent me put me into a rage, they state don't let it bother you, merely a form letter we send everyone. It states that they have review the medical evidence and find that there is a chance it will improve, are they kidding me, I was WILD when I read that, false hope, ya think, we would all be standing in line for a MIRACLE CURE and it went on to say, he will be check periodically to see if his condition is improving and if deemed it is, he will be taken off the program, I THINK NOT!
We are NOW in a CATCH 22 situation, he has a retirement fund, 401K and they state if he is to continue to be receiving MEDICAID, it has to be all spent within a 6 month period and cannot be gifted to anyone, the amount has to come down to $1,500.00 in our account. That 401K was meant for his retirement and for other important reasons.
I am sure someone on this site has been faced with similar circumstances and can give me some advice. I feel like telling them, forget it, it is not worth it to me, to have you now governing our 401K.
My DH got into a state run high risk pool that was formed specifically for people who couldn't be insured. The problem is that it wasn't cheap but it was a stopgap for that two year waiting period. Check to see if your state offers anything like that. I am sorry but I don't know if the premiums are on a sliding scale. Our insurance agent told us this was what we needed to do; otherwise I might never have known about it. Our agent told us that our state pool is actually underused.
We went from health insurance at his work to COBRA from his work, when that ran out we went to the state high risk pool for DH. Very expensive for him. And DD and I went to private health insurance. He stayed on the high risk until Medicare kicked in. We had to wait for two years for that. Now with Medicare we have to buy supplemental and prescription for DH. We have an almost paid for house and some savings. So trying to protect what little we have. With the new health care reform, I am now totally confused as to who can get what. And what help is available.
I confess, I know little about these various avenues for getting medical care and protecting your 401K....however, I can feel and hear your pain in your post. This is one thing you might want to check into immediately because time is important.
Have you considered taking his 401K and purchasing a home? I believe the home would be protected from the other benefits you would get and you would have a place to live for the rest of your life. I don't know what state you live in but, maybe you could purchase a home for the amount of your 401K...at least the gov. couldn't take your home while you are living in the home.
Also, please tell us your ages so that when others read your post they may know things we don't know depending upon your age. Is it possible your dh could apply for SS disability?
colin, his employer has to by law offer him COBRA for his medical insurance for up to 18 months. In case you don't know what COBRA is, it is his current health insurance offered at the full cost. For example, let's say he has single coverage (only he is covered) and pays a monthly premium of $500.00, but the true cost of the coverage is $1000.00/month. His employer has to offer him the same coverage at the $1000.00/month cost. Yes it's pricey but he will still be covered and you won't have to worry about denial due to pre-exisiting conditions. There are strict requirements with COBRA-your husband has to elect the coverage within the timeframe specified (usually 30 or 60 days) in writing and the premiums must be paid on time otherwise the coverage can be cancelled. Is there someone in the HR department you could call and discuss this with so you know what his/your options are? Be advised, they may not discuss any of this with you if you do not have a DPOA, so make sure you have one.
You must do this very quickly BEFORE he is laid off for medical reasons. Also, you need to consult with a certified elderlaw attorney regarding trying to protect your/his assets before he goes on Medicaid. Otherwise you will be required to spend any assets over $105,000. It doesn't matter why he saved the money in his 401k, once approved for medicaid he will not be allowed to have assets over the $105,000 limit.
COBRA will cover the next 18 months, then as blue and marche said you will need to have him covered by the state's high risk pool for the remaining months until he qualifies for medicare. Let me know if I can be of futher help with your situation. Please act now!
I forgot to add - if he is a member of a labor union, contact his rep to see if they can help you as well.
Have you contacted your local Council on Aging office? Every state has one, but they might have a slightly different name. They will probably be able to tell you what options are available to you. And their services are free. In our state there is also a state office that deals with insurance matters, and they can give you more information.
In our case, DH was on COBRA almost until medicare kicked in. It pretty much cleaned us out financially, but he was able to see a multitude of doctors for dementia and other health issues.
There is also supplemental help you can get for medicare that will help with your deductible and copays if your income is limited. You have to apply for it, but it's very simple. It saved us a good deal of money until DH went on Medicaid.
I wish there was one place you could go to find out everything that is available. For years it seemed like I had a part time job researching what DH needed and ways to get help paying for it. So I know it is very, very hard to track everything down. I wish you luck, and also success.
My DH's age is 54 and I am 57, soon to be 58. His work does not have a Labor Union. I have placed calls to his employer to find out what the premium will be for Cobra & leave voicemails and receive no call backs. The company he worked for is huge and they do not want to deal with me being his DPOA, for what reason, I am not sure. I have always been pleasant and professional, it is like they think, I might sue them, due to the line of work he was doing, prior to his DX and it has never, ever, even been brought up. I am covered under his health plan and it will end for both of us on April 4, 2013.
I thank everyone who has written to me with advice. I agree, I wish there was a one-stop store, one could go to, to gather ALL information. I thought I would get some kind of communication through the mail already from his employer, seeing why his short-term disability was ending on April 4th.
Aside from the disease process itself, very little scared me more than the issues of Medicaid and guardianship.
General advice that I received was to see an eldercare specialist attorney a year before I even thought Medicaid might come into the picture. Not later because it could take some time to set up finances, property etc.
Well, not having the gift of prophecy I went to one right away. She talked about this trust and that trust and this and that shelter and it was well beyond me.
As it turned out my general lawyer was just as current and explained it to me so that it was easier for me to understand.
She explained that Medicaid was part federal and part state. A house owned up to $750,000 (the highest and depending on state), a vehicle up to $50,000 and prepaid funeral expenses are exempt; also exempt are assets up to $105,000 as stated above.
You may already have the information at hand to calculate your husband's cobra rate.
If he receives a w-2- take a look at it and see how much he paid annually for health insurance. Then look at the box for employer contributions for the same information. Add both and divide by 12. This assumes no major changes in plan or cost for that year and should get you close.
colin, try not to get too upset about medicaid wanting to make sure that there is or will be no improvement. My brother is fully disabled with arthritis and on medicaid. He gets worse every year but every year or so his doctor needs to fill out forms stating he is not getting better nor will he ever get better. Just bureaucracy...
Same as for my husband who receives a small payment from his company's long term disability policy. They need the paperwork filled out. What don't they understand when the doctor writes it is a terminal condition?
Another thing to check on which might help your finances: Has your husband worked for the company to be vested in their pension if they have one? Can he file for early retirement due to full disability. The SSDI he receives would show he is fully disabled and unable to perform his work. My husband was able to do this from his job and the payments are the same as if he had retired at full retirement age.
Colin. The $1,500 sounds wrong. The rules are different in every state but as a Medicaid spouse you are entitled to keep a car, a house and $XX. The amount varies by state and may be up to around $110,000. The purpose is to help avoid spouses of sick people from going into poverty.
I recommend you see an eldercare attorney with Medicaid certification. Medicaid rules vary by state and change every single year. Your need an expert to help you navigate the system and help you preserve your assets. They aren't cheap but most will not charge for the first hour.
Keep in mind that Medicaid is a poverty program so you have to have your assets drop below a certain amount before it kicks in. If your husband was single the amount of assets he could keep is much lower, the $1,500 you mention, than you as a surviving spouse.
Many 401k plans allow you to withdraw money with no penalty if the owner of the account is disabled. Get a Durable Power of Attorney for your husband so you can make legal decisions for him. Get a Medical Power of Attorney so you can have access to his doctors. The MPOA is FREE and should be available at hospitals and medical offices. Do this ASAP while your husband is well enough to sign them.
We have to assure our private long term disability company every year that my wife cannot work. Same with SSDI I think. Unfortunately there is a lot of fraud going on and these companies and agencies need to check. You cannot take people questioning your husband's condition personally, they must ask.
There are other things you might be able to do. Convert 401k plans to annuities in your name. But you need someone to help you.
And don't feel bad about you FIL helping you. My FIL helps me and I don't know what I would do without that help despite having a good job. Oh, I'd be spending my wife's retirement money right now, which we are going to need when she moves into assisted living.
colin, I agree that you've received excellent advice here. The financial aspect of this disease is daunting to say the least and very frustrating. We were in a similar situation to yours. My DH was self-employed and I was working so I carried the health insurance. The day after his diagnosis in July 2010 I lost my job. I took the COBRA and we stayed on it for the maximum 18 months. In the meantime, DH was approved for SSDI and we also had a private disability policy. After the COBRA ran out, we went into our state's high risk pool. DH was only in it for two months until Medicare kicked in but I've remained in the pool. It's not cheap and I do wonder how the new health care law will affect it.
I'm really sorry you're experiencing such stress with this. Most of us have been in your shoes and we all sympathize. It's a rough road, but somehow we're all managing to travel it. Hang in there!
colin, the company should have mailed you something in writing regarding your husband's (and your) COBRA eligibility, but I believe by law they have 30 days to notify you after the termination. OK, now here comes mama bear!!!! CALL THE PRESIDENT OR CEO OF THE COMPANY NOW!!! This cannot wait because today is your husband's last day on the payroll and you need answers to your insurance questions. I worked for a very large fortune 100 company as the person who was designated to respond to all employee letters, complaints, and inquiries. Calling the president/ceo is a very effective way to get your questions/problems addressed quickly. Every large company has a person dedicated to responding to inquiries. Also when you call, ask for the presidents email address and follow up your call immediately with an email so you have your situation documented.
Before you call, make notes on the nature of the problem (can't reach someone to discuss health insurance options, what benefits, if any is he eligible for as a retiree, etc) and the outcome you expect (to receive a call from the person best quailifed to answer the questions and provide meaningful information). It would also be good to say this is urgent because today is your husband's last day on the payroll and you must get this resolved today.
I am sorry you have to do this in addition to everything else going on in your life, but it's essential because you both need health insurance coverage. By the way make sure the company sends you a letter of creditable coverage...you will need this to show to another insurer to prove you had healthcare coverage and could favorably impact the "pre-exisitin" issue.
LFL-there is no president or CEO, the company was sold and it is being run by trustees. I never got a call back after calling 3X's already to the party that handles the healthcare issues over the last two weeks. From the time my DH got done, to present, no one wants or will return my calls, I have called the main plant and the same applies there. A month ago I did get to speak to one woman at the main plant via the phone and she said everything as far as paperwork on COBRA and the 401K would be forth coming as soon as his employment ended, which was today.
Please also be aware that your h's company may offer you a cash settlement or a % of salary- either as a pay-off to you or a contribution to health insurance.
I defer to others here who may certainly know more than I do about this. LFL and Judith, as well as others who have posted here have more information than I do.
I just want to say that (even today) I have had these struggles and want to wish you the best.
Colin, if you are offered a cash settlemnt of some sort, most likely they will require you sign a confidentiality agreement and a contract. Do not sign anything until your attorney has reviewed it and you are clear about what current and future rights you are signing away. Don't be surprised if they tell you you (or he) has to sign immediately or within 24 hours in order to receive the money.
Please keep us posted. We're here to help if we can.
This may be an off the wall suggestion, but can you call one of your local TV stations that has a consumer advocate? Your story is dramatic (and not to trivialize it by any means) would make for good TV, if it would not bother you to go public. Sometimes that type of public exposure gets companies going.
If I were you I would send emails to anyone and everyone in his company requesting the info for cobra. Emails leave a better trail than a message they may be able to erase and may be of help to you if they do not come forward in providing you what you need to continue on cobra.
Also, you may want to see if you can use his 401-k to pay up the full 18 months of the cobra coverage.
Here is something that came up this week. I started calling my wife's retirement plans to see if they needed something more than a DPOA for me to access her money when that becomes necessary. Some financial institutions do not accept POA and require their own paperwork to be filled out, so I would need my wife to sign any such paperwork now when she is able. Anyway, I also asked about avoiding penalties when withdrawing funds from the plans while she is younger than 59. New York Life said, since she stopped working due to disability, they must be told by her last employer about her disability in order to avoid the penalty. So make sure you have his company notify the company that handles his 401k about his disability.
Sorry it has taken me awhile to get back to all of you. There has been NOTHING easy dealing with my DH's company & my attempts to tie up loose ends for my DH, it has been a constant fight to receive anything, including COBRA information, finally today, I received it and as I expected - it is going to be unattainable, $539.00 for spouse only and $1,069.00 for us both. He receives $1500.00 per month so for now, he will stay with MEDICAID until they start dictating what he can & can't do with his 401K. - that aint happening, he worked too many years for them, hard work and 60 plus hours per week. I have spent the last two weeks trying to make contact with his company regarding the 401K, leaving numerous voicemails, then finally speaking to the right party and each person keeps pasting the buck but at one point, I spoke to the administrator of the plan and the local company show him being laid off ( a medical layoff) but corporate had his status as terminated and I had to straighten that out in fast fashion because if corporate list it as a termination then his 401k will be penalized, due to the fact he chose to cash it out before the age of 59 and he would have to pay taxes on it also. He was let go because of being medically disabled. So right now I am waiting for his company to send that documentation to his 401K which they stated they would do asap but as of today, still nothing has been received. I can't stand incompetent people who are lazy and do not follow through.
Agreed but the squeaky wheel gets the oil. Follow up often enough and they may give you a higher priority. Anyway sorry you have to struggle with them and good luck.
I was checking on my wife's 401K plans to ensure we can start drawing on them before she is 59.5. For the two older plans I would just need proof of disability from SSA, but for the last, and largest, plan I needed to call her last employer to notify the financial company that she had left due to disability. Fortunately they took care of the issue in 24 hours. I was surprised, I thought that collecting SSDI would be sufficient proof of disability.
He will have to pay taxes on cashing out the 401K plan, but usually if someone is disabled they can avoid the 10% penalty for early withdrawal. Note that some plans will charge the 10% no matter what but all of the plans I've contacted waive the penalty in cases of disability.
My plan is to not touch the retirement plans until L is in AL, because our higher medical costs will mean not paying taxes on withdrawing from the retirement plans.
I'm sorry that you are having such problems. They should be able to quickly resolve this issue.
When my husband lost his job in 2003, age 56, he was able to cash out his 401K and only pay tax on it. Because he was over 55 he did not have to pay the penalty. From the sounds of it not all are that way.
If the 401k owner is disabled by SS then he/she should be able to withdrawn funds from the 401k without the early withdrawal penalty (10%) if he/she is under 59.5. You will need to provide the SSDI letter of determination that the owner received to the 410k plan administrator. The owner should not be charged the early withdrawal penalty but will need to pay income taxes on the amount withdrawn.
The income tax may be offset by the amount you pay in healthcares costs if they are in excess of the 7.5% of income.