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Jobless and Diabetic: Some Folks We Know
A few weeks ago, our community was shocked to learn that one of the most respected D-bloggers, Scott Johnson, was let go from his company. Although losing a job for anyone in this economy is a hard blow, it is especially worrisome for those of us with a serious, chronic medical condition like diabetes — which requires expensive constant monitoring, daily medications and regular visits with the doctor.
So how are Scott and others effected in our community handling their job loss? And what resources and strategies are they relying on until they are able to regain employment? A few mini case studies that may interest you:
Photo: simulation only
Scott, who just turned 34 and lives in the Minneapolis area, was ironically laid off from a diabetes company — the Cozmo division of Smiths Medical. Since this just happened recently (we all found out Cozmo was going out business on March 25, the same day Scott found out about the lay-offs), Scott is still receiving severance pay and medical insurance coverage for about another six weeks, at which point he will switch to his wife’s medical insurance coverage. Unfortunately, Scott says, “It is more expensive and offers less coverage for DME equipment and supplies.”
Most people who are laid off are eligible for an extension of their health insurance through the Consolidated Omnibus Budget Reconciliation Act, which most of you will recognize as COBRA, which allows workers to pay to remain on their employer’s health policy for up to 18 months. However, for most people who are unemployed, paying for COBRA is ridiculously expensive. A study released by Families USA found the average national premiums cost for family COBRA to eat up about 84% of the average unemployment benefits, and for individuals, it’s about 30%. This leaves very little for a mortgage or rent, utilities, food and other basics.
Melissa, a 28-year-old living in Massachusetts, lost her job after her position was combined with another one, requiring more hours than this part-time college student could afford.
“My employer knew this upon offering me the position and while they did not anticipate that I would choose to refuse the position, they left me no choice,” Melissa says. “I was able to stay with the company for a month after the decision was made due to freedom in my schedule.”
For Melissa, living in Massachusetts comes with the benefit that the law actually requires every individual to have health insurance, so for those who are unemployed the state has a system called Commonwealth Care. The cost is based on income, and since Melissa has no income, she doesn’t pay anything. Although the insurance covers prescription medication and doctors’ appointments, she’s limited to only 5 test strips a day, which is… well, problematic for someone trying to maintain tight BG control. If Melissa had gone with the COBRA option, the cost of coverage would’ve been $500 a month.
Bernard, another well-known D-blogger and Massachusetts resident, was laid off from his job during company-wide cuts in January. He currently is on COBRA, but says he hopes to soon join an organization (IEEE, or local chamber of commerce) that would give him access to affordable insurance including “pre-existing condition coverage.” Bernard was lucky that COBRA covered a trip to the emergency room during a recent low blood sugar episode.
Tammy, a 43-year-old from Alabama, was laid off from work just weeks before she was diagnosed with type 1 diabetes in December 2008. Because she had not finished transferring to COBRA, she has to pay all of her hospital bills out of pocket. She averages $300 a month on her diabetes medication, and she only makes $230 a week on unemployment, leaving very little to finance the rest of her life. Luckily, Tammy’s family has been able to assist with paying for her medication. Tammy’s very fortunate that her employer has recently asked her to come back, so she’ll be returning to work in mid-May. She kept a positive outlook throughout, saying, “Never give up, brighter days are ahead no matter how grim your situation looks now.”
Did You Know…?
The Obama Administration has created a new plan for COBRA, which mandates that the federal government will pick up 65% of the cost of COBRA premiums. Wow. Downside? While people can remain on COBRA coverage for up to 18 months, the discount only lasts 9 months. Also, if you quit your job or were fired for misconduct, you’re out of luck. In addition, you must have lost your job after August 31, 2008. But for someone eligible, like Bernard, it’s a godsend. He says his current monthly costs are around $1300, but with the new subsidy, that amount will drop to around $460.
Finding health insurance coverage while healthy is a headache, and finding it while dealing a chronic illness can seem near impossible. Bernard’s advice: “First of all, don’t panic. Take stock of your financial situation and immediately drop any unnecessary items (cable bills, newspaper subscriptions, eating out, morning coffee, etc.) See if there are other ways to reduce costs. I’ve sold some older technical books on Amazon, which gives me more shelf space and about $250 to date. I also connected with several places and managed to get some short-term programming work. Figure out whether your unemployment insurance will help. In Massachusetts, there is a program that pays for some of the COBRA costs if you qualify.”
Some more good tips, courtesy of the community:
- Find out what your maximum allowance for diabetes supplies is and stock up (think of it as a diabetes savings account).
- Remember that you must transfer to COBRA within 60 days of losing your job.
- Pay attention to the fine print of some of those “too good to be true” health insurance scams — it probably is!
- Find out what state-assisted health insurance programs there are (like Commonwealth Care) and if whether you, or your family members, might qualify.
- If you have children, they may qualify for federally supported children’s health insurance.
- Check out the Foundation for Health Coverage Education (coverageforall.org), which offers mucho info on a variety of health insurance programs (although whether diabetes is an immediate disqualifier remains TBD).
Although many agree that universal health care — or at least some variation thereof — is necessary to aid the millions of Americans now without health insurance, the question of how this will happen is still up for debate on all fronts. Until then, we’re pretty much on our own figuring out how to pay for it…
Have you lost your job and are dealing with finding health insurance? Share your story and any guidance you might have in the comments section below. As usual, I will keep you all posted on anything ground-breaking as it appears.
Explore posts in the same categories: Diabetes Essentials, Holy @#$! Amazing Stories
Wow.
I am blown away on all fronts.
First, when do I move to Mass????????
Second, it’s tough for someone who Is employed, has a chronic illness and the employer is a small business, at least in NY it’s tough.
I’ve had a “story” for the past two years when I decided to take the job I currently Love and will Never leave so long as my boss keeps me.
Living with and maintaining any chronic illness is tough.
Everyone has a story.
There are always circumstances and situations to consider.
I wish I had “global” advice.
Tammy got it right, “Never give up….”
And I haven’t. I just now work and live within my means, as I always have but now I truly understand that and am finding ways to actually do it without stressing too much.
Best of luck to all of you!
Posted by: CALpumper | April 22nd, 2009 at 7:13 amWhen I lost my job in Aug 07, we stayed on COBRA while I did some self-employment stuff. When I tried to obtain individual insurance, I was immediately denied by everyone I applied with due to my Type 1. When my 18 months of COBRA ran out in February, my only option was to apply with my state insurance pool plan, which required that I had used up my entire COBRA eligibility. If I had somehow managed to get individual insurance back in 07, and then later got dropped, I would not have been able to apply with the state plan and would have been out of luck.
Posted by: Ken | April 22nd, 2009 at 7:27 amYou say:
“The Obama administration has created a new plan for COBRA, which mandates that the federal government will pick up 65% of the cost of COBRA premiums. Wow. Downside?”
For a downside, how about the question of the cost to taxpayers? How does Mr. Obama and the congress expect to pay for it? More taxing our children?
Posted by: Eric | April 22nd, 2009 at 7:58 amI sincerely sympathize with people who don’t have insurance coverage (my own mother recently spent a good deal of time in that situation), but we all have to understand that there is no free lunch; all of these government-backed plans cost lots of money (in most cases MORE money than something in the private sector because of the inherent inefficiency of government agencies [again, I am directly familiar, my wife is a federal employee]). As your friend the Happy Hospitalist (http://thehappyhospitalist.blogspot.com/) says, the FREE=MORE strategy/mentality is NOT sustainable. I’d rather see the current congress and administration show some creativity rather than just propose that Uncle Sam pay for everything.
Blimey – how scary. Thank God for the free-at-point-of-entry National Health Service in the UK…we don’t know how lucky we are.
Posted by: Tim | April 22nd, 2009 at 8:08 amI’m soooo lucky to have a job with fairly good insurance. The thought of being without scares me. I’ve done COBRA and state health insurance before, and the monthly premiums were awful.
If anyone in job trouble needs a couple Humalog KwikPens, give me a shout. I’d be happy to share.
Posted by: Kathy | April 22nd, 2009 at 8:20 amThanks Amy. And thanks for the comments everyone.
It is a scary time for anyone I think, but living with diabetes adds another huge layer of worry to deal with. I feel fortunate that my employer offered a small severance package, as that is not required and many do not.
Posted by: Scott K. Johnson | April 22nd, 2009 at 8:49 amSeeing that newspapers are folding left and right, I have been hoarding supplies, just in case. Especially my insulin and my pump stuff. We have just been given a mandatory 2 week unpaid furlough, and I have great fears for what the future brings. For now, though, I’m preparing for a “what if” scenario, and cleaning up my resume.
Posted by: Mandy | April 22nd, 2009 at 11:42 amReally great post. Full of information, all the right details. The case of Melissa was interesting. It doesn’t say if she’s a type 1 or 2 diabetic, but most of us with type 1 who try to maintain tight control would find it very hard, if not impossible, to safely subsist on five test strips a day, especially if we have a regular exercise regimen. Seems to me one of the first lines of prevention the Obama administration should consider is making glucose testing supplies free. The savings in prevention of short- and long-term complications might be huge.
Posted by: jacob | April 22nd, 2009 at 11:47 amDoesn’t anyone see that the problem ultimately lies with the profit-hungry insurance giants? They are the ones setting these absurdly high and unaffordable premiums while making billions off the backs of sick Americans. I don’t understand why we stand for the current system.
I have 2 insurances, the primary being Anthem Blue Cross. It’s an individual plan because, as someone with a chronic illness, I would never ever join a group employer-funded plan. That is a huge mistake. I keep my own plan, which is the best way to make sure you’re never “between plans.” I would never get rid of my individual coverage and join a group plan because those are dependent upon external factors such as employment. And if I wound up in the hospital while “between insurances” I would be in a very bad situation.
So, I keep it for catastrophic purposes. On a day to day basis, however, the coverage is useless. And this is the crux of the problem. Insurance companies are the ones setting the premiums, dictating terms to physicians, and deciding how many test strips we’re “allowed.” Why do we allow this horrible system to continue?
Posted by: Lauren | April 22nd, 2009 at 12:06 pmThese stories are the types of things I fear could happen to me – the best thing to do is be as prepared as you can be. I change my pump infusion set every 3 days (the doctor and well-respected guidelines say every 2-3 days), but I refill my prescription as if I change it every two. This way, I have accumulated a “stockpile” of infusion sets that I can use when and if no longer have insurance. Fortunately, this doesn’t expire. Also, since the number of test strips and amount of insulin I use varies slightly each day, my Rx sometimes comes up for refill before I’ve depleted what I’ve got. I refill it anyway, so I have a reserve (although when it comes to strips, I’m really not ahead of the curve on usage – sometimes I use more than expected and dip into my reserves). The moral of the story is to be prepared.
(the “captcha” phrase to submit this comment includes the word “cured”. Oh, the irony…)
Posted by: Scott E | April 22nd, 2009 at 1:08 pmThx to Amy for this impt post. While we’re at it — Anyone need NovaMax strips – the ones that communicate with the MMD Paradigm pump? I have extras (from doing what Scott E. recommends above, and then switching meters). Let me know – we can discuss off-line.
Posted by: T1 in Boston | April 22nd, 2009 at 1:43 pmScott’s story is painfully familiar. Living with a chronic illness makes looking for a new job particularly scary. Do I disclose, will this job have more stress than I can handle, how do I ask about benefits without showing that I really need them, etc.? Will I find a job before my health coverage runs out? Ford factory workers know it’s impossible to predict what the future marketplace will look like. But I’ve found that my clients who plan careers with their chronic illness in mind are able to be in as solid position as possible (see my post w/3 things to think about: http://bit.ly/RXEEw)
Posted by: Rosalind Joffe | April 22nd, 2009 at 3:22 pmBernard F got a new job relatively quickly – He was smart because he developed solid skills transferrable to a variety of industries FYI -Read more about Bernard F’s career story http://bit.ly/bD9K on my blog,WorkingWithChronicIllness.com because there’s a lot to learn from his approach.
I have been between jobs several times and have relied on COBRA coverage, particularly when I left a job to go to grad school and when I’ve been between staff jobs and chose to freelance long-term. I also picked up a group plan for freelance writers when my COBRA ran out and the monthly fee, while pricey, was comparable to COBRA. Paying my health insurance bill was the first thing I did in those months and it was just what I did.
Posted by: Lyrehca | April 22nd, 2009 at 3:46 pmHaving been in a similiar situation in the past, I know how stressful if can be to afford diabetic medication and supplies, even with COBRA coverage.
Good luck to all!
Posted by: Sanjeev Bhadresa | April 22nd, 2009 at 6:12 pmThe Massachusetts health reform plan has brought significant help to many low and moderate income people struggling with health insurance.
In Massachusetts:
- insurers cannot take health status into account. The price of insurance is only based on age and zip code. They are not allowed to even ask about your medical history, or prescriptions, etc.
- all people must have coverage that includes prescriptions. This spreads the cost of prescriptions across everyone in the insurance pool, so that people with health needs don’t have to pay extra.
- people can buy individual coverage at group rates. Both groups and individuals are all part of the same rating pool, and pay the same rates.
- the Connector, a new state agency, makes it easy to buy coverage and compare plans on a fair apples-to-apples basis. The Connector only gives it’s seal of approval to plans to provide comprehensive coverage at a good value. Their website is http://www.mahealthconnector.org.
- for low income people who can’t get Medicaid, the Commonwealth Care program provides sliding scale premiums, with good coverage. There’s a choice of plans, so diabetics can compare the coverage from the different carriers.
- Massachusetts has long provided assistance to low and moderate income people in paying for COBRA, and now when you add in the new federal subsidy, the laid-off worker only has to pay 7% of the premium.
A great service will help anyone figure out how to get health insurance in Massachusetts. Call the Health Care For All HelpLine at 1-800-972-4232.
The Massachusetts model is being considered as part of national reform. Let you Congressional representatives know if you support expanding affordable coverage.
Posted by: Brian | April 22nd, 2009 at 9:36 pmDon’t forget the option of store-brand test strips. They are easily half the cost of the name brands and some of the chains use the same manufacturer for the meters. I picked up a Target brand meter for $8.00 and the strips are half of the price of the J&J strips and the lancets are very inexpensive.
Posted by: Jim D | April 23rd, 2009 at 7:11 amAlso, the manufacturers have a lot of “free meter” promos which usually come with a sample vial of strips and lancets, so in a pinch this could be a way to get some free supplies.
If you lose your job, you usually have a little time to use up your Flexible Spending Account before you’re officially “laid off”. The good thing is that you can spend all of it without having actually paid for all of it. So if you elected to put in $1200 for 2009, and you got laid off in March, even though your employer only deducted about $300 from your Jan/Feb/March paychecks, you can spend the rest of the $900 without ever having paid it. It’s true, unbelievable, but look it up on the internet. actually, i just found it at http://www.creditfyi.com/Creditpedia/Manage-Your-Money/How-To-Prepare-For-A-Possible-Layoff.htm (see #7 on that page)
Posted by: Mark | April 23rd, 2009 at 8:48 amThanks for the post. Perfect timing. As a T1, I was laid off this March and had several months’ warning because I was asked to stay on to close the division of over 800 people (I was one of the last 5 to turn off the lights). Even with the extra time to search for a new career/job, I wasn’t getting many bites with my applications. With twins and another one on the way, my family is concerned but thankful for COBRA and knowledge that we’ll find a way. Anyone looking for a proven IT Systems Engineer with a MS in CompScience, BS in Microbiology, and a record of adding value to a business through IT? Willing to relocate with own funds.
(Sorry, shameless plug, Amy).
Posted by: JasonJayahwk | April 24th, 2009 at 10:56 pmMy son (diabetic since 1993) who is currently a full-time student and has coverage through my employer is going to be registered for less than 12 credits next semester and will lose insurance. I am horrified. Any advice on any programs/coverage (we live in NY) which he might be eligible for? He doesn’t have any income, and I can’t afford COBRA.
Posted by: Lana | April 28th, 2009 at 3:10 pmWOW! Just a reminder, the government doesn’t “pick up the tab”, WE do.
Posted by: Fernando | April 29th, 2009 at 7:58 pm