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Posted 4/22/2022 2:49 PM (GMT 0)
I don’t even know where to start.

Jeff went into work last week and his entire department was laid off.

His health insurance ended Tuesday.

Jeff is running out of time … he doesn’t have time for his care to be delayed.

Getting LU-177 is proving to be a nightmare due to the insurance companies denying it.

We saw Dr. Kwon today and Jeff is a priority. He’s one of the patients whose case will be reviewed tomorrow in regards to LU-177.

Dr. Kwon: “I don’t want you to die while they’re trying to figure things out.”

Should this whole LU-177 thing not work out, Dr. Kwon wants us to see an oncologist in the cities. He’s just as underwhelmed with Mayo’s oncology department as we are.

In lieu of starting Jeff on a PARP inhibitor, he wants him on immunotherapy, likely Keytruda.

If this happens it won’t disqualify him for LU-177, but instead might buy him some time.

His PSA more than doubled in less than a month … currently 589.

This is all so horrible.

We should know something more concrete by Monday/Tuesday.

In the meantime, Jeff is gonna look into COBRA and apply for medical assistance through the state.

Without insurance I don’t know how he’ll get established with a new oncologist much less receive care and/or if we get the go ahead on LU-177, no way they’ll move forward with it.

This can’t be happening. ☹️

~ Stephanie

#teamjeffgallagher
Posted 4/22/2022 3:18 PM (GMT 0)
Hey, Stephanie,

I'm so sorry. Healthcare is the US is a $#!+show. Have you looked into COBRA. It's bound to be expensive, but maybe will buy you some time? We'll be praying for you.

Donna.
Posted 4/22/2022 4:02 PM (GMT 0)
Oh my...this is absolutely the *last* thing you need. I agree with the comment above about COBRA--it may not be the cheapest solution, but I would think that you don't want to re-negotiate anything with a new insurer at this point.
Posted 4/22/2022 5:03 PM (GMT 0)
Stephanie, so sorry to hear of the recent events. I believe the American Rescue Plan is still in effect. I also believe it covers 100% financial assistance for Cobra Insurance to those who have lost their jobs. That helps to keep their current insurance intact. It looks like it is good until 2023. There is a qualifying income to be eligible like Obama Care. My best wishes that this all gets resolved quickly.
Jack
Posted 4/22/2022 5:12 PM (GMT 0)
When it rains, it pours... This is a terrible sequence of events that would challenge anyone to stay sane.

Cobra is a law for companies with 20 or more employees so this should be checked out first although expensive since the full insurance cost has be paid but would continue coverage until you can make other arrangements.

Remember you are in MN and there are options like MNSURE that have a special enrollment for those losing health care. I would get on that right away to find out what needs to be done.

https://careerwise.minnstate.edu/jobs/joblosshealthcare.html
https://www.mnsure.org/new-customers/enrollment-deadlines/special-enrollment/

Hang in there.,,
Posted 4/22/2022 8:42 PM (GMT 0)
So sorry Stephanie, no words.
The immediate answer to the insurance issue is Cobra. Unless the employer is a really small company, they have to offer it. Tat will give you a safety net until you can find your footing.

I'm praying as i am sure everyone is, that you get the LU-177 thing straightened out.
Posted 4/22/2022 8:43 PM (GMT 0)

When it rains, it pours ... and this seems like a DELUGE!

I'm so sorry for the stress and worry this situation brings to TEAM GALLAGHER ...

I hope there are viable options - benefits --- insurance coverage extensions ...

It might be wise to find an advocate or expert who can advise you or lead you forward --- in terms of seeking benefits and insurance coverage.

I'm sending you my 100% support.

I promise to keep in touch!

With caring thoughts,
CYCLONE - # Iowa State University
Posted 4/22/2022 10:10 PM (GMT 0)
He continues the exact same coverage under COBRA for at least 18 months. Yes he has to pay for it, but he will get assistance from several areas including unemployment benefits. He will have no interruption of insurance coverage. Period. Cobra is automatic for two months without electing it to protect against a lapse in coverage. This is his protection under the law.

Plus his insurance can not end on Tuesday. All coverage is based on the first of the month following an occurrence. His insurance on a group basis runs through the end of this month. All individual coverage is the same. Call the insurance company for confirmation or the insurance commissioner of your state. File a formal complaint and threaten suit against anyone that said his coverage ended before the end of the month. Did he receive a severance? If so, that means he is still employed during that period and still insured.
Posted 4/23/2022 1:42 AM (GMT 0)
Stephanie,

So sorry to hear this new development. As if you guys did not have enough on your plate.

Good news is he will probably be eligible for COBRA. I had to use it in the past, and it is ok. Downside is that you will now also have to pay the part of his health insurance that his company used to pay, but that's better than having no insurance. There is also an added 2% admin fee.

Here are the details. Know you are overwhelmed, but it's critical that you keep him on his insurance if possible.

https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/cobra_fact_sheet

Robert
Posted 4/23/2022 11:25 AM (GMT 0)
Stephanie, immediately Jeff needs to file for Social Security Disability. He can do so under the Compassionate Determination method due to his serious situation and no longer working. This will fast track the process. The day he files is the day benefits start so he will get a back payment to that date. So don’t dally.

The filing is easy and he can use the information he knows based on the diagnosis and treatments he has been receiving. He can start the process online and then if necessary meet a SS representative in the office. Usually for SSDI I recommend using a specialist attorney, but his case is so clear that many have done so on their own successfully. If he wants to use an attorney start the search today so you can make a contact on Monday and get the ball rolling. There are several great websites with information and I would begin with the ss.gov for the instructions. Very easy to use.
Posted 4/23/2022 12:54 PM (GMT 0)
Stephanie,

Like others have said, COBRA is a sensible short-term option for continuing his insurance now that he has been laid off. It will continue his same, exact coverage for up to 18 months. I've used it before and it is expensive but it does work. It will allow you to continue to argue with his balky insurance company without interruption. The HR department at his former employer will probably help with the paperwork.

Sorry so many things are happening all at once. I know this layoff is the last thing you need.

PeterDisAbelard.
Posted 4/23/2022 1:43 PM (GMT 0)
Stephanie, I don't know if anybody has mentioned this but Jeff needs to sign up for Social Security Disability immediately, he would qualify I think it's called the compassionate disability where he could start getting payments almost immediately. You guys can do almost all of it online, with Jeff's health history and your records from Mayo I would think that it wouldn't take more than 30 days. The other reason you want to get signed up right away is to get Jeff on medicare which will help greatly with your medical expenses! I was at the Hope Lodge with a young gentlemen whose diagnosis wasn't as severe as Jeff's but still stage 4. He was getting radiation at the Mayo and was seeing Dr, Kwon. He was telling us the only way he was surviving money wise was from disability, He had signed up and two weeks later was approved for SSDI and then in 3 months he started getting medicare. This was back in 2018 so don't know if things would still work this fast in today's world but you definitely have to get signed up. JNF is really knowledgeable about this stuff also and am sure he could offer some ideas. Make sure when you fill out the information online that you cross your t's and dot your I's!!!! take your time. From my own personal experience after degenerative disc surgery, bad heart valve which I find out next week at Mayo if I can get another year, and degenerative arthiritis, I signed up for ssdi but didn't qualify for the compassionate so I had to wait 6 months for it to start and then two years for Medicare. Don't feel bad about getting ssdi that's what it is there for!!!! My hat is off to you guys. You are what hero's are made of!!!!!! Larry
Posted 4/23/2022 2:17 PM (GMT 0)
Basically COBRA applies to companies with 20 or more employees both full and part time. Certain exceptions for som churches, non profits and some federal work forces.
Posted 4/24/2022 11:55 PM (GMT 0)

JNF said...
Plus his insurance can not end on Tuesday. All coverage is based on the first of the month following an occurrence.

You’re absolutely correct. Jeff was mistaken. He does have insurance coverage through the end of this month. My apologies for the misinformation.
Posted 4/25/2022 12:15 AM (GMT 0)
His insurance will continue uninterrupted via COBRA for at least 18 months. He has 60 days from his formal severance to elect COBRA so there is no lapse in coverage.
Posted 4/26/2022 6:38 PM (GMT 0)
When I left my job the HR department was very helpful. I think it's worth a phone call.
I too quickly applied for SSD
Social services may offer emergency aid for medical but depends on income
With SSD you qualify for Medicare with SSI automatic Medicaid.
Maybe some form of emergency Medicaid.
Good luck

Glen
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