Help Please. Frustrated.

[roadrunner]

State: TN

Client: Male 62 years old

Situtation: I have a client that currently has health coverage through his wife's employer. (Cigna) Husband had a brain hemorage in November, 2013. First of March 2014, the husband exhausted his coverage for Nursing Home, and was sent home. They have paid $8000.00 for home nursing care in March and will continue to have the same bill each and every month as they have no coverage for that expense left in their plan for the year. Plan renews in November, but husband won't qualify to purchase on his own, as "affordable" credible coverage is offered through her employer to all spouses.

He does not qualify for Disability as his wife is still working and their annual income is roughly 56,000 a year.

He does not qualify for Medicaid, again income too high.

He does not qualify for Medicare, he is too young.

The brother in law is a client of mine, so I am trying to help in any way I can, but I am at a loss.

The wife has full Power of Attorney for both Medical and Financial care.

Any thoughts or avenues I haven't thought of??

Thanks in advance.

 

[moonlightandmargaritas]

Any thoughts or avenues I haven't thought of??

Maybe. You'll have to check the Tennessee statutes, but the best avenue may be for divorce - then have her adopt him. Seriously.

 

[roadrunner]

Moonlight -
She is actually looking into taking early retirement (she is only 52)

Depending on what her retirement/pension looks like this may throw him onto SSI. and then medicaid.

If her pension is too high.. the best Platinum plan would still save them money and perhaps provide better coverage or close to what they have now.

She would then become his private home health care provider. Thus erasing the 8000.00 a month in medical.

Bottom line, right now she is working to just cover medical. I know they have already cashed out some of his 401K. It is a slippery slope.


The divorce idea is a thought. Challenge is that they are from another country and not sure their religious beliefs are in line with that option. But, I will add it to the list for them to look into.

 

[moonlightandmargaritas]

The divorce idea is a thought. Challenge is that they are from another country and not sure their religious beliefs are in line with that option. But, I will add it to the list for them to look into.

A tough concept for some, no doubt! The financial needs may trump their religious beliefs. Hope they see that - before it's too late.

 

[Ann H]

He does not qualify for Disability as his wife is still working and their annual income is roughly 56,000 a year.

Disability insurance is based on the ability/inability to earn an income. It is not based on assets, or unearned income, or the wife's ability to earn an income. You didn't say anything about the husband's job prior to this medical event, but if he was working, and if the employer had disability insurance, he may qualify. Otherwise, they might want to get started with the Social Security Administration on SSDI (Social Security Disability). They probably won't get SSI, due to the wife's income, but SSDI is based on HIS ability/inability to earn an income.