In part 1 of this series, the author explained how some fortunate timing helped his uncle fight cancer without high premiums or big out of pocket expenses. In part 2 of the story, he explained how a cancer policy helped his uncle replace his lost income while he was out of work. In part 3, he discusses his uncle’s latest ordeal and explains why people should purchase insurance before they have a need.
I started this story by talking about how my uncle got health insurance. Though he had some pre-existing conditions and neglected medical issues, my uncle was able to take advantage of the health law’s guaranteed issue provision and open enrollment period and sign up for coverage just in the nick of time, right before being diagnosed with cancer.
As we all know, though, that’s not the way other types of insurance work. Most lines of coverage are not guaranteed issue and don’t have an annual enrollment period; instead, people must have the foresight to purchase them ahead of time, before they have a claim to file. That’s exactly what my uncle did when he purchased the cancer policy back in 1996, and it saved him nearly 20 years later. He also purchased an accident plan that he’s never had to use, but that’s a good thing: we purchase insurance not because we have an immediate need but rather because we don’t know whether we’ll need it or not; our hope is that we won’t.
Unfortunately, there are a couple products that, with the benefit of hindsight, we really wish my uncle had purchased before he needed them. In January of this year, my uncle started getting a tingling feeling in his arms and legs, and quickly he began losing use of all four limbs. He quickly sought medical attention and ended up having surgery to replace three disks in his neck. The hope was that it would immediately reverse his symptoms and he’d be back to normal. That didn’t happen.
After the surgery, he spent a couple days in the hospital. His recovery was slow, but he was able to get up and move around with the assistance of a walker. He went home for a few days, but instead of getting better he seemed to decline. When he could no longer push himself up in his chair, he called the neighbor who in turn called an ambulance. He spent the next few weeks in a hospital and inpatient rehab center before being moved to a skilled nursing facility. That’s where he is today.
Under Medicare, beneficiaries are covered for up to 100 days of skilled nursing, and my uncle has about 90 days left if he continues to show improvement. After the first 20 days, his supplement will cover the cost-sharing amount. That’s great if he gets better and gets to go home, but his progress has been slow so far and we’re beginning to worry about whether he will make a recovery. What we’re now learning is that at the end of the hundred days (or sooner if he doesn’t show enough progress), he’ll need to move out of the skilled nursing facility and into an actual nursing home. He definitely doesn’t have the money for that and will need to apply for Medicaid.
Qualifying for Medicaid will require my uncle to spend through most of his cash – he can’t have more than about $2,000 in the bank, not that he has much more than that right now. He’ll also have to direct his social security checks to the nursing home; that money cannot go toward other expenses. He’ll have to get rid of his new truck and we’ll have to figure out a way to make his monthly mortgage payments for him, though we don’t know at this point if he’ll ever go home. In short, it’s a mess.
It would be less of a mess, though, if he had a long-term care policy. The majority of people don’t, and a lot more folks end up needing assistance than most of us realize. While my uncle would still have a serious health issue even if he had LTC insurance, at least we could spend our time tending to his medical needs rather than worrying about the financial impact of his condition.
Our other concern, though we don’t know yet, is that the cancer may have returned and could either be causing or contributing to my uncle’s condition. We pray that isn’t the case and should have an answer soon, but if it has returned, his prognosis will not be good. While we don’t want to think about it, we also wish at this point that my uncle had had the foresight to purchase life insurance. Even if we get good news about the cancer, it’s very unlikely he would qualify for coverage.
So what’s the message? What’s my motivation in sharing my uncle’s story? It’s simple. As an insurance agent, you sell products that can and do have a huge impact on your clients’ lives, and that means that you have a responsibility to help them understand the need for the products you sell. My hope is that you take that responsibility very seriously. As you sit down with a client, you should ask yourself one very important question: does the client have another trusted insurance advisor to recommend the coverage they need, or are you the only one? In most cases, you’re it. What that means is that if you don’t tell the client about cancer insurance, accident insurance, long term care insurance, life and disability insurance, etc., he or she is likely to go without these important protections. And, as we learned from my uncle’s story, that can have devastating consequences.
Insurance is expensive; we all know that that. But it’s also critically important. While we can’t insure everything, we should most definitely buy insurance for the most important things. If you’re focused solely on health insurance, as a lot of agents are, then in my opinion you’re skipping a very important part of the conversation.
AHCP Closing Comment: The author of this article has asked to remain anonymous. His hope is that his uncle’s story will inspire you to ask more questions of your clients and to do your best to make sure they have the coverage they need. At America’s Health Care Plans, we have many of the products mentioned in this series, including health insurance, Medicare supplements, cancer policies, accident plans, long term care insurance, and life insurance. If you have some gaps in your product portfolio, or if you’d like some ideas about how to sell any of these products, please give us a call today – we’re here to help.