Chronic Illness/Disability + Money

Oh yeah, I meant getting into a new field where you can WFH. That’s what I had to do as well! My jobs were always on-site only until, well basically that wasn’t an option, I had to re-start over at the bottom in a new field and took a huge pay cut, but definitely worth it and better than $0.

Do you mind sharing what your field is and how you went about it? I’m always interested in WFH options but it seems like most people I’ve heard about do it by negotiating with their current company. I’m not sure how one would find something exclusively WFH.

I actually switched into my career to accommodate my disability. And working from home could be more lucrative but would mean I’d have to take on other risks and do pieces of the job that could aggravate primary disability.

What I really need to do is figure out how to get my ever-changing admin team on my side. I get one set under control and then they switch (noting that I’m not the one hiring or the reason. They quit)

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Ah, I gotcha. Well I hope you can figure out some kind of workaround <3 I know it sucks and is hard.

ETA: Deleted other post for privacy. But feel free to PM me if anyone here wants to know about remote work.

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Hm, we don’t have dependents and I can’t be claimed as a dependent.

Tax dependent isn’t the same as life insurance dependent. It sounds like, if you rely on your partner’s income, then you are a dependent (or beneficiary) for life insurance purposes. Good solid term life insurance is a very good idea in that case.

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Oh ok. I should probably look into this.

Oh no…another thing to research :wink:

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Yes - exactly - you depend (at least partially) on his income (or benefits like health insurance) and insurance would be to cover those expenses. Since he is covering some expenses - you may want to see if tax filing status “Head of Household” would apply. It’s been too many years since I tried to be a VITA tax prep volunteer to remember the details, but it should be easy to figure out.

@anomalily - would the amount of insurance needed be = the amount of stash needed (e,g. Expect 4% SWR so 25X expenses = good target life insurance amount).
V

Usually for term life insurance, we recommend 10x annual income, as if you get to full stash levels it gets expensive. So for a $50K income earner, it would be $500,000 term life policy. I usually prefer to extrapolate from expenses, not income, but in this case we’re making decisions based on loss of an income earner, so that makes it easier.

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Need to rant… Buckle up, this is long. I was diagnosed with Crohn’s at 15, and ever since my surgery at 17, I’ve been mostly symptom free and I’ve just done a lot of tests, appointments, and medicine to stay that way. Very #blessed.

Through this, I’ve learned more than most people about how insurance works, and since my symptoms are well managed, dealing with insurance is BY FAR THE WORST PART OF HAVING CROHN’S (other than actually having the disease).

Again, #blessed because I actually have always had good insurance… but… even though at this point, I’m an expert at working the system, sometimes there are still things that come up that I can’t handle. Like @anomalily, I take a biologic medication that normally would be 10k per month, but through copay assistance programs, I pay almost nothing and after February, because they’ve taken care of my out-of-pocket max. NOT SO THIS YEAR! I changed jobs in Oct 2018 and stocked up on and rationed my medication because co-pay assistance would not cover my deductible the 2nd time. I could afford to eat the deductible, but on principle, I didn’t want to. My new company’s insurance uses an exclusive pharmacy for most of the medications, and this pharmacy has a separate company for their specialty medication (aka mine).

There was a snafu at the first of the year with getting my medication ordered (as usual, the first of the year is always rough, getting prior authorizations updated, etc, it never goes as smoothly as you’d think). In the end, my medication got shipped. All is fine? No. For some reason, my insurance company covered all but $40 of my medication. In theory this is great? Except nothing got contributed to my deductible or OOP max. So I had to pay out of pocket for my next dr’s visit that I had purposefully scheduled for after the first shipment so that my deductible would be met at that time. Is anyone else confused? These are the mental gymnastics I go through all the time.

At one point, I called the pharmacy to find out why this was billed weirdly. They directed me to call specialty pharmacy. Specialty pharmacy directed me to call insurance company. Then insurance company directed me to call pharmacy at which point I yelled at the person on the phone. I yelled that I understood that it was not their fault, but I had just gotten the run around and was frustrated. I gave up.

I order my 2nd shipment for the year, and this time it bills as expected. My deductible is now covered and my OOP max is half way there. Ok, whatever was going on at the beginning of the year is fixed. I should be good to go after my next shipment. NOPE! My 3rd shipment was billed in the same weird way as the first shipment, so I didn’t make a dent in finishing my OOP and I’ve now had to be responsible for a few more medical bills in the meantime. Why would they not be billed the same consistently? Who can answer my questions? What will happen with 4th shipment? I DON’T KNOW!!!

Again, I can easily afford these costs (for now) but I make a lot of plans assuming that the OOP max is going to be covered. I’m getting a colonoscopy at the end of the month (get it every 2 years, yay!) and those are actually very expensive, so I’d like to not use that to finish my OOP max off. Big pharma owes me that money and somehow my insurance company is not letting them pay.

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Following along. SO sorry to hear about all of this run around just to get your medication and live your life. How frustrating.
I’ve purposely avoided having very obvious medical issues diagnoses or treated partially for this very reason.

For US people- really important bill was just introduced at the federal level for step therapy.

Step therapy or “fail first” is is an insurance industry utilization management tool that means the insurance company can require you to try drugs they prefer before getting the drug your physician recommends. This is BRUTAL if you switch insurance and have a conditioned managed by an expensive drug. For example, I had to go through a bunch of drugs that I knew didn’t work and gave me brutal side effects before I could get on my (effective) drug because of insurance requirements - even though my physician and medical record made it clear I should not try the (cheaper) drugs first.

The arthritis foundation and the american cancer association have been working at a state levels to try to block this practice from being legal, but this is the first time it’s been introduced as a federal bill~!!!

If you want to send a letter of support to your congresscritter to ask them to support, or co-sponsor the bill, check out this link to send them a quick message.

As someone who has been affected by step therapy AND someone who has worked for a congressperson, this shit matters. And really has a huge impact on finances and treatment of chronic illness and disease.

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Thank you for sharing this. Fucking ridiculous.

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Omg that is awful. I hope it gets shut down.

Thought I’d revive this thread as I just received some news from my insurance company that may affect others here. Starting in 2021, it is optional for insurance companies whether to count medication assistance $$ (from the pharma company) toward your deductible and max-out-of-pocket. I just called Blue Cross Blue Shield to ask them what they plan to do and those dollars will no longer count toward either the deductible or MOOP. Only dollars paid by the actual member will count or (and I quote) “it’s not fair for other customers who are not taking expensive medications and who have to pay their deductible themselves”.

So, this obviously affects insurance and health care costs going forward. :angry:

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Yup, I switch plans in 2 months and I am so fucked up over this. The new plan won’t confirm for me what is going to count after countless hours on the phone. I am going to have to pay $8,500 out of pocket per year or get a plan myself With no subsidy as there is only 2 High OOPM plans on my work options. I hit my max co pay assistance at $12K per year which means I’ll use up everything available to me in the first quarter of the year.

I also can’t get confirmation on costs for my drug On the new formulary because they’re Speciality and not required to give me the same info.

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I chose my new insurance plan yesterday. I’ll be paying $3961 all in (premiums + deductible/out-of-pocket max) for the year. My relatively “cheap” total is due to my low income; otherwise it’d be more, but not sure how much. I plan on ramping up the PT in 2021 since it’ll be paid for insurance by February (after I pay for meds and lab tests in January-February). It’s a sad situation when I am happy with this outcome. Healthcare will be over 15% of my budget.

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It’s open enrollment and I’m trying to decide how much to put into my FSA.

Realistically, I can definitely max it out, BUT in order to do so I have to be willing to put up with our crappy benefits provider, who contests about 50% of my FSA usages…even though they’re the same every week. Why is this so complicated. Harumph.

Between PT, regular therapy, prescription costs, etc, I spend way too much time each week submitting claims as it is. Dunno if it’s worth the tax savings for me to jump through more hoops…

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Ughhhhh… that sucks.

Do you have a HSA-eligible plan? Is there a possibility that an HSA vs an FSA would be a better fit since you can “pick your own”? I’m assuming you’re going for a lower deductible plan if you have high expenses, but might be worth running the numbers.

Do you know about how much you save in taxes? (I.e. your FSA max * your marginal tax rate) That might help you make a decision once you know if it is $200 or $400 your are getting paid to argue with them.

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Fortunately / unfortunately, my marginal rate is 35%, so my hypothetical savings would be a little under 1k. Hard to say no to that…

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