I am searching for someone with experience or answers to some of my question. I made the choice to have treatment at a CCC. I have a 21 month old son in daycare and a wife in school. We live in KY. Our income last year was a pretty descent income.

My wife quit her job last year though to return to school to get her degree. With my salary and normal overtime we would have been ok. At the end of Nov. I had and MS exacerbation and then got my cancer Dx on 12-29-06. I have short term disability, employee paid long term disability, and my health insurance has been great so far. My std ends this week and I will start my ltd at 80% pay.

I just finished my tx but expect to have a radical neck dissection in 2-4 weeks. I was informed that at six months from the time I went on std even though I had worked on and off after the first day of std, my company will no longer offer me my insurance and will have to apply for COBRA insurance until I return to fulltime. Also that eventhough I do not expect to be permanantly disabled I have to actively seek social security disability. I thought my ltd was to cover times like this. I guess I didn't understand. My question is, should I seek a lawyer for this part to ensure I am getting the proper benefits of my insurances, KY laws ect?

My wife also has checked with the schools to see if she could get help for the upcoming fall semester and they acted as if it would be almost impossible to do until the winter semester due to our taxable income last year. I understand that but is there not hardship considerations? We also have sought help with childcare and have ran into the same wall. Last years taxable income. This is really frustrating because I made my treatment decisions based on feeling safe that with all of my insurances, help for my wife and son on things that people who can't work get help with, ect we would be ok. Now it looks a little grim.

Now I am not ungrateful for all the blessings we have been given but even with what seems like my responsibilities fullfilled we will not get help until it's basically to late. I'm trying not to get into the whole anger thing about people who abuse the system getting everything they need, but people who have insurance,pay taxes, and do the best they can, have an awful lot of trouble recieving any help.

So here's my question, is there anyone who can help me navigate this system to get the assistance that we need? I do not want the assistance that people who don't have insurance, or jobs, or anything need. I want that to be there for them. I'm seeking the assistance that I feel I should receive from the gov. since I have always paid taxes. I also want to make sure that my employer and insurance companies are really giving me all the benefits that I am supposed to receive. Can anyone help me with this? I am not the type that digs deep into all of this stuff so I need help getting started and navigating. If there is even anything I can do.

It just frustrates me that my wife and I have been trying so hard and it still looks like she may have to drop out of school or we will be financially devastated by the time this is over with. It makes that question hang out in my head of where's my government when I need it, as I have no choice when it needs something from me. I'm sure we have all felt this and I don't want that anger and frustration in me while I'm trying to fight this. I thought if I could get some direction I wouldn't have to get angry over it all. Thanks for your time, any help or guidance would be appreciated. Lee

Lee


Cobra payments can be crazy high...here is some info

The Medical Support and Benefit Branch (MSBB) consists of the Medicaid Policy Section, the Case Processing Section and the Medicaid Technical Support Section.

Medicaid Policy Section

Develops procedural instructions for the Medicaid Program
Reviews state and federal regulations regarding Medicaid
Serves as a clearinghouse for policy clarifications
Provides technical assistance as requested by DCBS field staff
Case Processing Section

Maintains working caseload of adult guardianship cases
Determines retro medical assistance for SSI recipients
Issues emergency medical cards for SSI recipients
Distributes material and correspondence to DCBS field staff
Technical Section

Issues replacement medical cards
Issues letters confirming Medicaid eligibility
Makes KenPAC provider changes for KenPAC physicians
MSBB is responsible for developing procedural instructions and forms for the Medicaid Program. MSBB also provides technical assistance to DCBS field staff and provides information concerning the Medicaid Program and Non-Emergency Medical Transportation (NEMT) for Medicaid recipients, other agencies, the general public and community organizations.

Katie Brown, Branch Manager
275 E. Main St., 3E-I
Frankfort, KY 40621
(502) 564-3440

Call them at least for Ins ...Let me do some more research for college info !! Alot of times you dont have to do medicaid they have other programs like spend downs or we have what is called family health plus ..which you pay for but alot less then cobra and we also have what is called healthy NY. I will check into more for you. But If you qualify for the MA I would take advantage of it ..like you said you worked and paid your taxes ..you are entitled in your time of need !!

Shar

lee

some child care info ...

Kentucky targets eligible children who:

Have special needs;
Receive, or need to receive, protective or preventive services;
Are children of teen parents;
Are children of parents who participate in the federally mandated welfare reform program (K-TAP); and
Are children of low-income parents who work and/or attend an education or training program leading to self-sufficiency.
Eligibility Guidelines
To the extent funding is available, maintain gross income eligibility at 150 percent of the federal poverty level for initial application and 165 percent of the federal poverty level at the time of redetermination or for families transitioning from KTAP;

Income Eligibility by Family Size Table

To promote parental responsibility, families with an income above $900 a month may be accessed co-payments. (The number of family members does not change the amount of the co-payment.)

Families that receive child care subsidies are responsible for paying the co-payment directly to the child care provider.

Quality and Accessibility
Incentives that are added to the daily rate for providers that are accredited ($2 a day), that operate nontraditional hours ($1 a day), or that serve children with special needs ($1 per child per day).


Market Rate Survey
A market survey of child care is conducted every two years. The most recent market rate survey was completed in 2005 and submitted with the CCDF State Plan. The results show that a family in Central Kentucky can expect to pay $24 a day for a child under two years of age or $21 a day for a preschool child attending a licensed center
The goal of this program is to provide access to quality child care that allows parents to work, attend education and training programs and/or to participate in the Kentucky Temporary Assistance Program (K-TAP).

Child care subsidies are also available for child protective services. Child care services through the CCAP are purchased from licensed, certified and registered providers.

The division contracts with five service agents to administer the program. For contact information click on the appropriate service area:

Audubon Area Community Services

lee
http://studentaid.ed.gov/PORTALSWebApp/students/english/PellGrants.jsp?tab=funding

here is a site for the federal pell grant so you can check it out ! I dont know your income but you should be able to find requirments on here

So my next step should be to call these numbers in Frankfort and see what happens? I am very grateful for your help. I have never been very good at what you are doing. I don't know if it's my lack of patience or the lack of frustration but something really turns me away from researching this kind of stuff. I guess it's time for me to get over it. Alot of it is that I don;t know where to get started so thank You agin. I will keep checking this post and I will return to update on any or no progress. I really respect and thank you for the help. Lee

Lee

Any thing i can do ..I actually like research ..LOL funny cus I never did, But now that I have so much time on my hands LOL.I would call those numbers to start. They can direct you to the right place as far as where you are located probably by county . Can I ask you a question now ? I see you had cancer in your tonsil and had it removed..mine was in my tongue, but now i need my tonsils done How bad is the surgery ..my surgeon said it is painful esp for adults >>>

I do not think it is Legal for a company, nor your insurance to DROP you in Mid-Treatment!
Call Legal-Aid...
Good Luck!
PeteyB

Thank you Sharlee and Petey, I just now got back online since I posted this thread. Sorry I felt really washed out for a couple of days. Maybe it was the overload of stress about finances. I'm going to get started on this Monday. Thank you both so much and thanks for the offer Sharlee I take you up on it. I don't mind research I just get impatient, but it's hard to do it with my little boy around to.

I will definatley check into that Petey. The way it was stated to me was that after being on disability for 6 months from full time the company would no longer be paying their portion of my insurance premium meaning I would have to pick up COBRA until I returned to full time. This came as a suprise to me. I am considered a salary exempt employee. I am paid salary but also am paid an hourly OT. The production workers in the plant are all hourly. There were only 10 of us paid this way. I have found that the only benefits handbook that was written was for the hourly production employees. There has never been a handbook for the maintenance dept. Hopefully they will staighten this out and hopefully it works out to my benefit. We'll see soon.

Sharlee thank you again. I will give an update on the help Monday afternoon hopefully. I'm sorry to hear you have to have your tonsils done. Your surgeon is twlling you the truth. I is pretty tough as an adult. Of course I can't really compare it to anything but it was much tougher than the node removals prior to it. I think it took me about 2 1/2 weeks to be able to swallow somewhat easy. I went straight into chemo and rad before I was actually fully healed. I thought it would make the side effects twice as bad but it turned out ok. The only real difficulty I have had is I haven't had the taste for anything since the tonsillectomy because they took 6 tongue biopsies as well. I've had the mucositis for about 3 1/2 weeks now and the tonsillectomy pain is about the same. On the pain scale a 6-8. but not constant, only when you swallow. They gave me roxicet and it worked pretty well. If you don't mind my asking is this a reoccurance. You are on my prayer list either way. Ask anything you need to know about the tonsillectomy I would be glad to share the knowledge I have. Thank you for your research. Keep ya posted. Lee

Hey Lee
Usually there is only one handbook, otherwise it could be considered descrimination.
I was similar to you. I was a salaried supervisor, with OT paid after 45 hours. But my benefits were the same.
READ the handbook carefully.
DO NOT LET YOUR INSURANCE LAPSE! Call human resources. If you are going on LTD, why should you have to pay, I Don't Know??? Maybe for your family?
You really need to find this out. Take my thoughts with a grain of salt.
THIS IS AS SERIOUS AS YOUR ILLNESS...
Good Luck, PeyeyB

Lee

I dunnoo if it is a recurrance. they dont see lesions or tumors however i have been put on antibiotics 3 times over past 7 weeks ( since surgery ) and nothing is working for tonsils..so they are comin out !!! then they will be biopsied. Just nervous LOL. 1 the not knowing and 2 another surgery ..ughhhh.. oh well i should be able to lose more weight this way right !! yea the neck dissection suxed but i dont know that it hurt..def uncomfortable..tongue hurt. dr says tonsils is painful for adults and that it would be good 2-3 weeks until i was completley healed or atleast eating good. OH well gotta do what ya gotta do right . Anyhow keep me posted after you check all your options ..i will try to find whatever I can for ya...you can even email or Pm me . Hope ya have a nice easter !!

|SHAR

I understand what you mean Petey but our benefits are actually different when it comes to STD ect. Salary recieves STD immediately where hourly has 60 day probationary period, the time of earning full pay is different ect. We don't have set work days in maint. so our whole attendance policy is different as well. Our policy has always been different because of the 6-7 day work week schedule. We have no way to earn sick time like the floor workers ect. That is why there is alwys confusion. It is on of thopse things that usually states it is left up to the supervisor's discretion escept when it gets to this point and there has been no guidelines or outline of benefits because there has been so few instances of this type. It has basically been handled with inconsistency. This past year our human resource manager was fired for some money issues. While talking to the new human resource manager I was informed of FMLA being used as STD by this individual for years. There are just so many inconsistencies. I have worked in hourly and this production salary for this company and it has always been this way, I just ended up being the one who will be off for 6 consecutive months. I just want to be sure that I get what I have earned and I am not toyed with. It is really easy to frustrate someone by sending them back and forth between HR at the factory level and Corporate HR. I have seen it done many times. In the end everyone is so confused that everyone is just happy to still be sane.I don't want this because my wife and I have really tried to cover all the areas we could and my poor wife has been carrying a huge load.

Bottom line though Petey is I don't have nearly the problem you do so I am sorry for being so long winded about my problems. I hope with all of my heart that you get something staightened out with your care. It shouldn't be this difficult for anyone to get care in a country as wealthy as this. Good Luck Petey, Lee