Thinking Ahead While Looking Back

A lot of people don’t give much consideration to certain workplace benefits like long term care insurance or consider life insurance policies beyond what their jobs offer.  The older I get, the more I look back and have a better appreciation for those who raised me and the struggles they faced. I’m currently only a few years younger than my mother was when she first entered nursing care.  She entered it young, at the age of 50. I was only 23 and found myself overwhelmed with caring for her on my own. She had suffered a series of seizures due to a brain tumor that was removed ten years prior that left her without the ability to walk and with a minimal vocabulary.  I cared for her for two years in the house I grew up in, but I found myself drowning without the financial resources I needed to keep her healthy and safe. At the time, I understood very little about insurance, and my mother never prepared herself beyond a 401K. She didn’t even work long enough to maximize it to its full potential.

After my mother’s seizures, I had to send her to a rehabilitation center. However, insurance wouldn’t cover much beyond the 30 days. I couldn’t bring her home due to her poor condition. The rehab facility offered to continue treatments for another 60 days if I paid $3,000 a month. I agreed since I felt they were taking excellent care of her, and she was responding to treatment. That was just the beginning of the draining of my bank accounts.

Unfortunately, she was underinsured for what she needed.  She had gone on disability, which was a year-long battle that required legal intervention.  Medicare didn’t kick in until two years after the initial application and after the approval of disability, which was still several months away. In those months, all our economic resources where exhausted. Ironically this needed to happen for her to qualify for Medicaid, which was the only way I could pay the $5,000 a month for a nursing home. That figure in today’s numbers stands at over $7,000 a month. The sad reality is that your financial health will determine the quality of life and level of care you’ll receive if illness strikes. It’s a harsh reality.

I probably wouldn’t have suffered that initial bankruptcy had there been plans in place like long term care insurance or had I been educated on how insurance works. I later found out that once Medicare and Medicaid kicked in, most of the medical expenses would have been covered retroactively, but the medical facilities didn’t want to wait. It was either pay now or move on. I do share in the responsibility of not properly educating myself and assuming that nursing facilities were there to help. They are a business first. I could write a book on the experiences I went through during my mother’s years of illness. There were other issues at play like my mother’s disability check being garnished due to a student loan she had taken out on my behalf that sadly outlived her. That garnishment needed to be paid to the nursing home since they required her entire disability check amount before garnishment to be sent to them to keep the Medicaid paying the monthly premiums. I never thought they would garnish a disability check for someone in nursing care, and I never thought I’d have to pay the difference, along with my student loan that I only managed to pay off last year.

Despite being only given a few months to live after her last major seizure, my mother managed to live ten years in a nursing home due to the top-level of care. I visited her almost daily.  She was an incredible mother, and my childhood was a happy one.  She was front row at every school play and every baseball game.  I was her miracle baby after she learned she couldn’t conceive a child, and I was treated as such for most of my upbringing. She passed at 60 when her brain tumor returned unexpectedly after being in remission for 20 years.  Her time on earth was shorter than I would have liked, and she dealt with circumstances that I don’t wish on anyone. However, life continues nonetheless in its tragic beauty.

The message I pass on is that it’s essential to be prepared. Life will not turn out as you expect it to. If you have access to additional benefits that would ease a financial burden on you or your loved ones due to illness or death, take advantage, educate yourself, and lean on those who have the knowledge. We’re out there, and it is why I am so passionate about what I do.

Written by Raul Lara, Small Group, Individual and Medicare Specialist, Sapoznik Insurance