- Nearing the End of Life
- Your emotions, or what you might feel as you near the end of life
- The importance of communication
- Making end-of-life decisions
- Advance directives
- Life insurance
- Money and income
- Choosing home care
- Choosing hospice care
- Physical symptoms in the last 2 to 3 months of life
- When death is near
- Facing death
- To learn more
If you have life insurance through your job and you leave your job, take your life insurance policy with you. You may be able convert it to an individual permanent policy with no proof of insurability, but you usually must do it within a month of leaving the job. You will have to pay the premiums out of pocket, but some employers have a policy with a feature called a “waiver of premium rider.” This means that you keep your group life insurance policy but you do not have to pay the premiums if you are totally disabled. They are paid by the insurance company instead.
If you have your own individual life insurance policy, keep it active by paying the premiums on time. Find out if the policy has a waiver of premium rider. If it does, this could save you money and keep your policy in effect.
You may also want to double-check the beneficiary you have named on your life insurance policy. Be sure the money is going to those you want to get it.
Health care coverage
COBRA: A way to keep your health insurance after leaving your job
Employer-based health insurance is usually a type of group insurance, which can be to your advantage. If you left work because of your health, you are entitled to keep your job-based health insurance for the next 18 months. But you must elect to do so within 63 days of when you stopped working. You can do this under the federal law called COBRA (the Consolidated Omnibus Budget Reconciliation Act). You pay the premium for your insurance plus up to 2% to cover costs. Your employer might help with the costs of your insurance premiums, but is not required to do so. COBRA applies to nearly all businesses that employ 20 or more workers. If you are disabled you can continue your coverage for 29 months. The Social Security Administration decides whether you are considered disabled. For more information please see our document called What is COBRA?
Individual and group health plans
If you do not have a COBRA option and need to look into individual health coverage, you may find that you are declined coverage by a number of insurance companies and HMOs. If you can find an insurer, the cost of these policies or medical plans will be high. If you are turned down as “uninsurable” and do not have medical coverage, check with your state’s insurance commission.
Under the Affordable Care Act (ACA), every state must have a Pre-Existing Condition Insurance Plan (PCIP) or high-risk pool for people who have not had insurance for 6 months or more and have cancer or another pre-existing condition. The program name will vary, depending on which state you live in. (Go to www.healthcare.gov/law/provisions/preexisting/index.html for the most current information on what’s available in your state.) Be aware that a state-supported plan may cost more than some other plans.
If you join a new medical plan, you may face a “pre-existing condition exclusion period.” A pre-existing condition is a health problem, like cancer, that you had before you joined your medical plan. When this happens, your plan will make you wait before they pay the costs of that medical problem. Find out if this is the case before joining a new plan. The wait can be a year or even more for some plans, and it may be too long for the insurance to ever help you.
There are some rules that can help you get health insurance coverage through an employer, if you have recently been insured through an employer’s group. If you have met the following requirements, then a pre-existing condition exclusion period may not apply to you:
- You have had medical coverage for 18 months (that’s why it’s very important not to stop your health insurance or let it lapse).
- You have already met a pre-existing condition exclusion period.
- You have not been without health coverage for more than 62 days. (Some states require an employer-based insurance company to cover your pre-existing condition even if you were without insurance for a bit more than 63 days.)
But if you are buying a plan that’s not group coverage (including high-risk pools), the pre-existing condition exclusion period is set by the state and can be many years or even unlimited. If you are getting a plan through someone other than an employer, the insurance provider can also impose an “elimination rider” that would keep your cancer treatment from ever being covered by that policy.
Remember that even an expensive insurance plan with a high deductible is better than one that won’t cover the care you need now. If you are having trouble with this, it may help to talk to an insurance agent. For more detailed information, see Health Insurance and Financial Assistance for the Cancer Patient.
It’s important to know that the Affordable Care Act (ACA) passed in 2010 affects pre-existing condition exclusion periods, among many other aspects of health insurance. The ACA already does not allow insurance companies to deny coverage of pre-existing conditions such as diabetes or cancer in children. This same ACA rule applies to adults starting in 2014.
Are you currently collecting Social Security Disability Insurance (SSDI) income? Keep track of the number of months you’ve been on SSDI. After you’ve been covered for 24 months, you will be eligible for Medicare. Some healthcare providers and hospices accept Medicare. This will give you some choices in your health care. You can learn more about Medicare by calling 1-800-MEDICARE (1-800-633-4227), from your nearest Social Security Administration office (check your local phone book), or by talking with your cancer care team social worker.
Adding to your Medicare coverage
If you are on Medicare now, you may be able to add more coverage with a Medigap policy or a Medicare HMO. If you get an add-on policy within 6 months of going on Medicare, you won’t have to wait out a pre-existing condition exclusion period. If you get an add-on policy after 6 months of being on Medicare you likely will have to wait before the plan would help pay your medical bills. Find out how long the wait is – it may be too long to help you.
There are still a few government programs that might help if you don’t have coverage. But to qualify for many of these programs, your income and assets must be very low.
Medicaid is another government program that covers the cost of medical care, but not all health providers take Medicaid. To get Medicaid, your income and assets must be very low, below a certain level. These levels vary from state to state. Some people try to qualify for Medicaid by giving away their assets, or selling them for less than they are worth. But anything you give away (or sell for less than its market value) up to 5 years before applying for Medicaid is still counted toward your income. So, giving away assets could delay qualifying for this program. Also, it’s a federal crime to help someone get rid of assets in order to qualify for Medicaid. You can talk with your social worker or contact your state Medicaid office about what’s required to qualify.
Last Medical Review: 06/12/2013
Last Revised: 06/12/2013