Possible loss of insurance due to MS

[gramorye]

I was diagnosed with MS 2yrs ago.  I went from walking to paralysis in a month, apparently I had been ignoring symptoms or something triggered it.  Anyhow, I had just gotten medical insurance through my work so I was lucky, as I was in the hospital for sometime, had IV steroids and months of physical therapy to relearn balance, walking, motorskills etc.  My insurance is based off the previous years hourly work per week.  So I had no issue.  But now I may be losing it since my doctor will not allow me to work more then 4hrs a week (due to a lot of reasons, I regained use of my body but I exhaust easy and a lot of my mental capacity isn't there and worsens when stressed).  I even had a relapse with just the 4hrs and having to raise my daughter alone, since my husband joined the military after my diagnosis (at the time I had been the financial support).  My employer requires a return to work form from the doctor, showing limitations etc., so they do know that it is due to my MS that I can not maintain the 20hrs a week needed to keep my insurance.  I mentioned this to our Human Relations person, even asking, so I will lose my insurance because I am only allowed 4hrs a week due to my disability?  And their response?  Yes.  I was a bit floored at that.  Sometimes I think, since I was fortunate enough to be able to walk without assitance most of the time (and can put on a show that Im ok, then go home and passout) that they think it's a joke that I'm just lazy etc.  I know that I have my husbands Tricare but having my other insurance has helped ease a lot of issues also (that and I don't want him to stay in the Army just for my health isurance), so I'm lucky there too unlike many who have only one source or none at all.  I would just like to know, since my loss of hours is due to my MS (since if I were healthier I'm trained in nearly all depts where I work and could easily get the 20hrs required for insurance) should they be able to legally revoke my insurance?  Would I qualify for COBRA (though those premiums can make one cry)?  Etc?  

[aj1964]

I have a fulltime job and have been working 20 hours a week for 6 month, dr suggested going onto 'ltd and company said they were willing to put me onto 2 hours a day,they have offered to give me a part time position but i said no because my insurance level would change and being single i need all i can get, go back to dr next week and he will have more forms to fill out...they just love those forms,anyway i think that unless he prints it very plainly that i can not work they will just keep giving me less and less hours, I still get 70 % of my wages but if I was to be put onto LTD then i would still have all my benefits but would not have to pay for pension, health or anything else those would all be picked up by the company,so financially it would do me better to actually be off...do not know what will happen next

[gramorye]

Thank you for all the responses.  I had to laugh, after the discussion of the high risk pool our new Governor finally signed the paperwork that would allow the pool (MN Dem Dayton). The governor who was replaced had refused the aid claiming it was why the country is in debt.
I did see one of my doctors and he was frustrated about the insurance since he knew I had been asking for over a year now to the proper people at work, about if I would lose it or not, and had been told not to worry.  So since I will have Tricare, my other insurance doesnt expire until end of March,  my doctors will continue testing and working to help me try for social security since my limit for work is less then 4hrs.  That and the fact my parents take my daughter for a day or two before I do work so I can rest and focus to work that amount.  I know it will be a long process but have a lawyer also that is a bit eager about this since I first applied 2yrs ago and it will go back to then.  Amazing what money does!  If only we all had more we'd be treated in a new light along with our disease.

[jensequitur]

I shudder to think of the trouble we'd be in without health insurance.  Me with my MS and my husband with a heart condition...  We both have preexisting conditions - which fortunately will be phased out in 2014 - but it still means that we don't have many options for health insurance.  Fortunately I have a full time job with health benefits - but what if I lose the job?  It gets very costly if you have to buy your own insurance.  And hubby is self-employed...

[HVAC]

They set it up so if you apply on line you will lose some one who worked at SSI told me this.

The real deal with insurance companies is they are mandated to make money for their shareholders which goes against paying any claim.

Don't get scared or overwhelmed that will do you no good. You do have to understand what you are up against. The MS Society has a book for the Newly Diagnosed which talks about insurance and fiances. They also have other help.

Just remember this is an expensive disease. The MRIs are $3000  and up. The DMDs are an average of $2500 and up a month. As you go you are on many medications. I am on 16. You have to see different Specialists not just Neurologists. I hate to say it but getting by with out good insurance with MS is a heartache. Even testing for SSI is expensive and the government does not pick up the tab.

I wish you the best of luck,

Alex

[gramorye]

Thank you for the responses.  I'm looking at COBRA right now.  I still have to see if I get on COBRA, since it is the same insurance, if I were by some miracle able to get to 20hrs if I would still be able to get the insurance the following year since I wouldn't have actually ever beem dropped off the policy.  Or if that is still considered being dropped off the policy.  If it is I will just stick with the Tricare, though I don't want to.  My husband a 1 1/2 yrs left and I don't want him pressured to stay in just for that.  I've been doing my research on the med I'm on and would qualify for help when we do lose insurance, so as long as I keep that up and it keeps working as it has that should be a litle better.
Yeah I'm sure the 2014 Insurance agreement is going to be high rates or very controlled to the point you need permission to pee (sry but I worry that one is true!).  Insurance companies loved to get paid but not to payout.  
I have applied but will be reapplying.  At the time I applied my health was so bad I ended up doing it online since I live too far from a SS source and traveling was not an option.  At first they denied me due to not enough quarters so put me up for SSI. They then decided that I could still earn 200-400 a week on just 4 hrs (Not sure what I could do Legally to get that money, BA and all) and denied me.  
Thank you for your responses!
Mari

[HVAC]

This is the stuff I do advocacy to try to help all of us every day.

This is the pit falls of insurance. The best option from the insurance would be if you could keep the Tricare. I hate for your husband to stay in though. My husband can't leave his job with the State for any reason do to my MS diagnosis and our insurance is getting ridiculously high. Your situation with your husbands job is different being in the Military especially if he is sent over seas so that needs to come first.

The second best would be to get into the Federal High Risk Pool which you have to be with out insurance for six months and not qualify for any group plan and have a pre existing condition. MS moves you to the top of the list after six moths.

The two problems are one there is a cap so as soon as the money is gone for the high risk pool its gone. Meaning first come first serve and it opened July 2009. Second this is what the new congress is threatening to defund so they may have the funding cut and all those folks are out of luck. On the bright side few know about it and are applying and if you are 50-64 the premiums have just decreased to help out that age group. 38 States also had high risk pools before the federal. Our state still has. The question is for how long with entitlement cuts the rallying cry.

Getting private insurance with MS is not really possible unless it is high premiums, high deductibles, or tricks in fine print.

In 2014 Insurance will not be able to turn down people with pre existing conditions but who knows what will happen between then and now. I also do not trust the insurance industry they accepted this too easily. They never do anything that easily.

If you can apply for disability do it now it is not a matter of pride everyone with MS is going to need it financially. Don't do it on the computer that is one way the SSI makes you fail at it. You can contact your local MS Society for advice. Also SSI is hard to get now and it is going to get harder. You will probably be turned down at first but that is all part of the game.

Alex

[sllowe]

Hi Grayome,

Welcome to the forum. You described your limitations so well and how it's so hard to work. It is true the amount of hrs dictate the insurance coverage.

Is the worrying about this fatiguing you too? Can you give your husbands insurance a go just so you don't lose the last bit of energy you have left?

Sorry you have to deal with this, but hope we can be here for you.

Thanks for joining us -  do what you can for now. It's all you can do and don't beat yourself up over it.

-Shell  

[gramorye]

Unfortunately I do retail so that isn't an option.  I had originally looked at other arwork areas that were a possibility for me and also asked about my insurance.  The responses I got were not helpful, as I was mainly told, well don't bring it up and maybe you'll stay on the insurance.  After looking at all the options the issue that came up was fatigue/mental exhaustion and having relapsed after just being back to work for a few months at the job of cashier my doctor has not ok'd me for anything else.   If it were something mobility related there would have been an option for me but since it is fatigue I am a bit out of luck, since I tend to lose speech coherency at about 3n 1/2 hrs cashiering (at least there I can just laugh it off with whomever I'm serving).  The company I work for is large enough to fall under COBRA but when mentioned yet again my HR person did not think I qualified.  Today I finally found the number to our main resource line for the company so hoping that I can possibly find help there.  

Thank you for your response

[Audrey_M]

Most group policies include a definition of covered employees, usually full time employees, with a definition of what is considered full time. Often it is 30 hours per week.

Unfortunately, if you work less than that you are not eligible for coverage.

If your employer is of the size that falls under COBRA, then yes, you would be eligible to elect COBRA coverage as the reduction in hours would be considered a qualifying event.

You don't mention what kind of work you do. Is it possible that you could telecommute with your doctor's permission to get to the required 20 hours per week for coverage?

Good luck.

Audrey