Monday, November 7, 2011

Hard lessons of Cobra, Medicare, and "Qualifying Events" or All I want to do is go on a Honeymoon!

Today, for the first time since my last surgery of 6 weeks ago, I was relaxed, lighthearted, feeling good. I was finally feeling like I could look across the horizon rather than being bogged down in my small recovery world. I was even preparing a blog post on healthcare issues I have been thinking about, especially a recent new experience I have had. A really positive one.

Great...I was starting to expand my life beyond immediate day to day dealings with healthcare, or the bureaucracy of healthcare...And, then ... you probably can tell...a Large Huge Bummer came from the sky....make that two:

#1: We have been living on my husband's COBRA since he was "separated" from his job. That is nearing it's end. He has been doing contract work, which has been good, but no benefits. We understood that we likely are eligible for an extension of Cobra due to my LTD (Long Term Disability), well today after countless calls over the last two months to the HR department from his company (which has been outsourced) we were told the "qualifying event" of my disability and receiving of Social Security had to occur within and only within  2 months of his being terminated, not after his severance ran out, or when we started COBRA etc.. so it is highly likely we will not qualify for a COBRA extension. The COBRA folks need more info from SS to determine whether or not we are eligible for "the qualifying event". Don't you love those words? I don't! (or at least do not find humor in them today)


#2 I call Social Security to get the needed documentation. They let me know when I started receiving benefits...which makes me think maybe we are not eligible for the Cobra extension which ends in 2 months. YIKES! So, I ask about the worst scenario case for me and my ability to get Medicare, since I think I am eligible. Well, apparently:
  1. Since I declined Medicare, which I did because we had good medical coverage and I was trying to save money not to pay two premiums for medical insurance, I was told that for each year of not taking medicare I pay a 10% penalty fee. The agent said, "The good thing is that premiums are dropping next year".
  2. I am not eligible for Medicare special enrollment (which means that you can sign up for it anytime if you have a "qualifying event"), because that is tied only to the "qualifying event" of my husband losing his job, not to the severance package period, or to Cobra benefit period. (Oh Shit)
  3. I am eligible for Medicare "Open Enrollment" in January of 2012. I would have to pay the penalty of 10% per each year of decling coverage....and, only after 6 months would I be covered....so that means there is a likely scenario I will not have medical coverage (Medicare) until next July.
Well, there went my day... too pieces. Unfortunately I am not like "some" who can deal without coverage. My condition is in constant need of attending. Maybe I will have to throw the dice and hope next year slows medically down after each year of surgeries, sometimes a couple or more. 

All I know is that the harsh reality of my life is that there is never a respite from constant medical attending be it bureaucratic or physical. I am pissed with myself for missing the boat on this. I normally am on top of all things disability, insurance, but I screwed the pooch on this. 

And, today, as I hoped to feel the release of the grip of the chains, and stoke the joy I had from yesterday's  Moose spotting on a drive my husband took me on, to have distance  from being a patient and the shit that comes with it. I am back into the fray again to sort out the details and make the best I can out of a bad situation. 

Not up for it today....and not sure how we are going to make this work.  Other people do so I guess I have to figure it out or not. The bottom line is that I am sick and tired this whole thing is my life. 17 surgeries, fighting for benefits, fighting for rights, fighting for care, plan ole fighting. Thank goodness I have great doctors, from whom I have to travel 1900 miles, and pay for the extra rent. But that is good...I would not even be writing this without them.

I close this with....I just want to go on a honeymoon with the man I love (we haven't yet because we keep needing to go to Colorado, for my doctors to keep holding me together). He has stood by me, going through surgery after surgery, rough spot after rough one, and the continuing onslaught. I thank him and his encouragement for that. He is steadfast in times of trial and tribulation. He is a solid compass and always says don't worry, we are going to be ok. We have so far been so. I guess I need to rest my rage in his caring hands, even when he is unsure of his future....that is courage....and I should take a lesson in that.

1 comment:

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