|Brian McFadden - The New York Times|
Currently, my health insurance is mostly paid for by my employer. I contribute a portion to the cost through payroll deductions, insurance company deductibles and out of pocket expenses. Since I am asymptomatic, I have told no one in my department that I have cancer and don’t intend to unless I need to take time off for sick leave. My company’s benefits department must know that I have cancer since it shows up in the company’s insurance costs. If my company downsizes and I am terminated, I could receive COBRA for 18 months. But due to the cancer diagnosis - a pre-existing condition, I am virtually uninsurable. I am ineligible for Medicare for another 12 years (age 65) and I am not poor enough for Medicaid. The Affordable Care Act (ACA) will allow me to get medical coverage should I be jobless and not out on disability. This is a huge benefit and relief to me as a cancer survivor. My cancer costs have been running about $70,000 annually and I am only taking monthly shots of Sandostatin and getting semi-annual scans – no surgery, chemotherapy or other treatments for the disease at this point. I have no idea how much it will cost for me to get into one of the pre-existing condition insurance pools but I have to believe it will be substantially less than the $70,000 per year my insurance company is currently paying for my treatment.
There is another issue that is a concern to me as an employed cancer survivor and unrelated to the ACA: What might I need to do if I wanted to change jobs? Suppose I interview for a new job and they want to do a pre-employment physical? I know the new company will not hire me if they know I have cancer. Is it appropriate to handle it with something similar to “don’t ask, don’t tell”? Should I not mention the cancer drugs I am taking if asked? This worries me as I am not sure if the new employer would know I have cancer before I got hired. But not disclosing my situation and then signing up for their health insurance could get me fired. If I am in one of the pre-existing condition insurance pools that are part of the ACA, do I still have to worry about this? These are things I think about as Wall Street continues to downsize and consolidate or if a better job prospect comes up. Having a pre-existing condition is a big problem from an insurance and employment perspective. I am hoping the ACA will help me if I ever need insurance if I am unemployed or retired before age 65.