Disability Is a Stage of Life
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Can't Afford the Emergency Room Bill
My husband recently suffered a catastrophic illness. We are fortunate enough to be covered by Short Term Disability through work, and are now exploring the options of Social Security Disability and Long Term Disability through his place of employment. To complicate matters, my husband is being laid off from work due to plant closure and I am a stay-at-home mom. What kind of preparations should I be making? Also, any advice about insurance options, drug discount cards, and dealing with Social Security would be appreciated. Other tips and hints would be more than welcome as well. Thank you.
Help from the Inside
As someone who has worked for Vocational Rehabilitation (an agency that helps people with disabilities find work), I have a wealth of information on things to do.
- Meet with the HR people at your spouse's place of work and find out every benefit to which he is entitled. Write it down and have the HR people write it down.
- If your spouse goes on SSDI (Social Security Disability Income), he will not be eligible for Medicare benefits for two years. This can cripple your family financially. Do your very best to maintain his insurance even if it means COBRA payments. It will be very expensive, but if has a hospitalization or chronic medical needs, it's the best choice.
- Discuss with his physician the likelihood of your spouse being certified for disability. This decision will impact every other decision you will make. Apply for SSDI now if this is a likely alternative.
- If this is not Worker's Compensation related, it's likely that you will need to go to work to keep the family's financial head above water. Don't wait to begin looking for employment and look for employment with benefits. Even if your spouse wouldn't be covered for a year after you go to work, it will still beat the alternative. Financial ruin is a very real possibility unless you have plenty of financial reserves, which few people have. I have seen plenty of lives affected by this tragic circumstance.
- Talk to someone at your local/state vocational rehabilitation office. It's possible that your spouse can be retrained for another job. If you meet agency guidelines, your spouse's training will be paid for by the agency. Job placement is also one of the agency functions.
- You will not be able to apply for services like food stamps, etc. until your income is in the ditch. Find out ahead of time what the criteria is in your state for food stamps and Medicaid. Call your local Health Department, Department of Family and Children's Services, Salvation Army, local food bank, etc. and find out guidelines for services for each of the programs. Guidelines vary and DFACS answers can depend on who you talk to and how experienced they are. Make sure you take notes and document the name of the person you talked to. Call at a different time and talk to a different person to verify that you received the correct information.
- Write everything down. Don't leave anything to memory or someone's word. Write down the name of the person you talk to and when you had the conversation.
If your spouse is disabled, you will have to take charge of many things you normally would never have to do. It can be done, but it won't be easy or fun.
Know Your Expenses
First of all, collect all your credit card statements along with your checkbook. Now, using pen and paper, write down the total amount of checks written and items charged for the last three months. This is usually a real eye opener and you can see where you can cut back on many things. Call your mortgage company and the utility companies and ask to speak with someone about your situation. Offer to make smaller payments each month. Next, go to the grocery and spend $100 on staples for your pantry!
With regard to your husband's disability, make sure you have good records of his medical appointments and all tests. You may have to consult an attorney if his application for benefits is denied. They usually charge a portion of your disability check, if they win the case, for a set period of time. Each one may be different. Ask questions!
Finally, don't be embarrassed to contact a large church or public agency for help. Once you have resolved the issues of keeping the roof over your head and having food to eat, you will be able to move on to some real decision making. Most importantly, remember to hug each family member at least once a day. Consider the hug your daily treat!
Contact Lawyer about SSDI
I've been battling Social Security for Disability payments for a year and a half now. The most important thing to remember when trying to get benefits is don't give up. Almost everyone is denied the first two times, so you need to get a lawyer. Usually they take a 1/4 of your back pay (which accrues from the time you apply until you actually get benefits), so you don't have to worry about paying for them upfront. A lawyer will also be able to help you understand other government programs for which you qualify.
Be sure to check out the programs through your Department of Social Services. Medicare and Medicaid, food benefits, heating assistance and even help neutering your dog are all offered depending on your income level. They will probably also know of free clinics or low cost clinics you can visit to keep up your doctor visits for Disability proof.
A program called BridgesToAccess.com will give you necessary medications for free depending on your income level.
Always be sure to inform your physicians and other places that you do business with about your situation. I've had bank fees waived, free lab work, and doctor's visit fees cut in half because I asked if there were any programs available to help the disabled. I've even heard of the phone company reducing fees for the disabled. Be sure to investigate all your options before paying for services you can't afford.
K. in Lake Lure, NC
Take Advantage of Support Groups
For the short term, talk with your local Health and Human Services office about any services for which you may be eligible. Depending on the age of your kids, you may be eligible for the Women and Infant Children program that provides necessary staples for your kitchen (milk, cheese, eggs, etc.). You may also qualify for assistance with medical bills, depending on your husband's eligibility for benefits through his employment. Since he's being laid off, find out about unemployment insurance from your local Department of Labor office. Another group to talk with is your children's school(s), if they are in public school. You may qualify for free or reduced breakfasts and lunches.
Also, you've probably already been given some information about support groups. Take advantage of these for yourself and your family as a whole as you make this transition. More than just helping with the logistics of this unplanned change in lifestyle, they are a wonderful source of encouragement and resources!
Continue with COBRA
I am happy to know that your husband is now being covered by his employer's short-term disability plan. It is important to note that most short-term disability plans cover employees for a maximum of 12 weeks of illness. Additionally, there is normally a six-month waiting period to qualify for long-term disability benefits. Although the original period of illness covered by his short-term disability plan will be counted towards the six-month waiting period for long-term disability benefits, it is important to note the obvious gap in which no benefits would be available to your husband. Thus it is crucial that he applies for disability benefits under Social Security as soon as possible so as to avoid a period of time without any source of income.
Since your husband is being laid off of work, he will be eligible for continuous health insurance coverage under COBRA legislation. Although coverage under COBRA is more expensive than when one is actively employed, it is less expensive than purchasing a policy on an individual basis. Since it is extremely difficult to find a decent dental plan on an individual basis, I highly recommend continuous coverage for dental benefits through your husband's employer under COBRA.
Also, depending on your overall financial status, you may be able to obtain medical coverage for your children through a state program when your coverage through your husband's employer terminates.
As far as discount cards for health, dental or prescription benefits are concerned, it has been my experience that the discounts offered are of little value. The discount is so minimal on these cards that I cannot recommend them unless the cost to purchase one of those cards are extremely inexpensive. Be very careful when considering the purchase of a discount card. Most of the time the organization offering the discount will state that a particular medical provider participates in their program. However, it is highly recommended that you call your provider (doctor, dentist or pharmacy) to confirm the fact they do indeed participate in the discount plan.
Don't Take "No" for an Answer
When my husband became disabled, we had to get a lawyer to deal with Social Security. After Social Security told us that my husband wasn't eligible, many people told us that they often say that until you get a lawyer. Be sure and get one that specializes in Social Security eligibility cases. Our lawyer worked on a contingency basis, so we didn't have to pay him if we didn't win. We did win, and after that, he was able to have his two hip replacements. If you don't have a good case and you really are not eligible, the lawyer won't take your case, but at least, you will know the truth.
Reader Shares Her Experience
My husband experienced a similar situation in April 2003. He had become permanently disabled in January 2001 and his company closed the plant in 2003 and transferred production out of the country. At first, we used COBRA, which was incredibly expensive. Meanwhile, I gathered every piece of documentation together pertaining to his disability in order for him to file for SSDI. He received his first payment within four months as he had a very solid case. His SSDI is a partial payment as he also receives long-term disability through his former employer.
After two years, he was automatically enrolled in Medicare and uses the Medicare Drug card with a 5% co-pay as we are both disabled and our income meets specified guidelines. He also purchased a Medicare Supplemental Plan A to help offset what Medicare doesn't pay. My husband is able to get the majority of his prescriptions for free through one of his doctors. He is enrolled in many patient assist medication programs sponsored directly through the pharmaceutical companies such as Pfizer and GSK. I pay $18 for a 90-day supply of one of my medications through Express Scripts. We both are enrolled in Pfizer's Connections To Care program and receive free medication as again we meet specified income guidelines as I'm sure you probably do. There is also Together Rx, RxOutreach, LilyAnswers, and the Orange Card just to name a few. AARP's website aarp.org gives information regarding Patient Medication Assistance Programs. Also try Access To Benefits AccessToBenefits.org/.
Anonymous in Michigan
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