FIL Stage 4 Cancer - Next steps

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JerLon
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Location: Western NY

FIL Stage 4 Cancer - Next steps

Post by JerLon » Mon Oct 23, 2017 4:18 pm

My father in law was just diagnosed with Stage 4 Metastatic Melanoma (he lost his eye to Ocular Melanoma 27 years ago).

While I am certainly open to medical suggestions, I am asking for personal finance advice.

I know my in laws do not have much (medi-share insurance through Christian Health Ministries) and probably no life insurance. They own their home and it was just sold (closing in 8 weeks or so) before the cancer diagnosis. Not a ton of equity in the house.

I have a few questions:

What are the questions I should be asking or documents I should be helping them get in order?

Is there anything we can do on the house in case he passes before closing? I don’t want my mother in law burdened with this house.

What else?

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Pajamas
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Joined: Sun Jun 03, 2012 6:32 pm

Re: FIL Stage 4 Cancer - Next steps

Post by Pajamas » Mon Oct 23, 2017 4:21 pm

JerLon wrote:
Mon Oct 23, 2017 4:18 pm
While I am certainly open to medical suggestions,
Medical suggestions should be avoided if you want the thread to remain open. See here: rules#rule-4c

I am sorry that your father-in-law and family are having to deal with this.

pintail07
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Re: FIL Stage 4 Cancer - Next steps

Post by pintail07 » Mon Oct 23, 2017 4:25 pm

Insist he enroll in the ACA during open enrollment.

Silk McCue
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Re: FIL Stage 4 Cancer - Next steps

Post by Silk McCue » Mon Oct 23, 2017 4:31 pm

Contact the Real Estate agent and ask what happens if your FIL passes before closing. I would hope that steps can be taken now to alleviate any issue with this if it isn't already established by state law. They can certainly answer this question. A quick web search on this topic found a reference saying if the seller dies the contract is still enforced (no idea what state that was based on). Condolences.

Silk McCue
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Re: FIL Stage 4 Cancer - Next steps

Post by Silk McCue » Mon Oct 23, 2017 4:34 pm

Their coverage under CHM is dictated by their participation level. Gold, Silver, Bronze and whether they participate in My Brothers Keeper. A recent communication with CHM will show this. They should then call CHM and discuss the situation and get guidance.

Globalviewer58
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Re: FIL Stage 4 Cancer - Next steps

Post by Globalviewer58 » Mon Oct 23, 2017 4:38 pm

Here's a link to an old post on a Death Book. You can see what documents are in place and then focus on gathering the remaining detail to help your MIL.

Is the Will current?

viewtopic.php?t=119346

cherijoh
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Location: Charlotte NC

Re: FIL Stage 4 Cancer - Next steps

Post by cherijoh » Mon Oct 23, 2017 4:43 pm

JerLon wrote:
Mon Oct 23, 2017 4:18 pm
My father in law was just diagnosed with Stage 4 Metastatic Melanoma (he lost his eye to Ocular Melanoma 27 years ago).

While I am certainly open to medical suggestions, I am asking for personal finance advice.

I know my in laws do not have much (medi-share insurance through Christian Health Ministries) and probably no life insurance. They own their home and it was just sold (closing in 8 weeks or so) before the cancer diagnosis. Not a ton of equity in the house.

I have a few questions:

What are the questions I should be asking or documents I should be helping them get in order?

Is there anything we can do on the house in case he passes before closing? I don’t want my mother in law burdened with this house.

What else?
My sympathy for you and your family.

Does your FIL have a will and other legal documents (living will, power of attorney, etc.). Those would be my first priority. If he dies without a will (i.e., intestate), the state rules determine how any assets would be distributed - you probably do not want that to happen. See this article for some general guidelines.

Does your MIL know where all the important documents are? Do they have a safe deposit box?

How old is your FIL? Is he eligible for or drawing a pension or Social Security?
Last edited by cherijoh on Mon Oct 23, 2017 5:19 pm, edited 1 time in total.

Levett
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Location: upper Midwest

Re: FIL Stage 4 Cancer - Next steps

Post by Levett » Mon Oct 23, 2017 4:49 pm

Don't just get educated on estate planning. Get educated on stage 4 Melanoma. Your FIL is alive.

Lev

JerLon
Posts: 133
Joined: Fri Aug 21, 2009 2:03 pm
Location: Western NY

Re: FIL Stage 4 Cancer - Next steps

Post by JerLon » Mon Oct 23, 2017 4:52 pm

Levett wrote:
Mon Oct 23, 2017 4:49 pm
Don't just get educated on estate planning. Get educated on stage 4 Melanoma. Your FIL is alive.

Lev
Yes, I am doing this. Just not on bogleheads.

JerLon
Posts: 133
Joined: Fri Aug 21, 2009 2:03 pm
Location: Western NY

Re: FIL Stage 4 Cancer - Next steps

Post by JerLon » Mon Oct 23, 2017 4:53 pm

cherijoh wrote:
Mon Oct 23, 2017 4:43 pm
JerLon wrote:
Mon Oct 23, 2017 4:18 pm
My father in law was just diagnosed with Stage 4 Metastatic Melanoma (he lost his eye to Ocular Melanoma 27 years ago).

While I am certainly open to medical suggestions, I am asking for personal finance advice.

I know my in laws do not have much (medi-share insurance through Christian Health Ministries) and probably no life insurance. They own their home and it was just sold (closing in 8 weeks or so) before the cancer diagnosis. Not a ton of equity in the house.

I have a few questions:

What are the questions I should be asking or documents I should be helping them get in order?

Is there anything we can do on the house in case he passes before closing? I don’t want my mother in law burdened with this house.

What else?
My sympathy for you and your family.

Does you FIL have a will and other legal documents (living will, power of attorney, etc.). Those would be my first priority. If he dies without a will (i.e., intestate), the state rules determine how any assets would be distributed - you probably do not want that to happen. See this article for some general guidelines.

Does you MIL know where all the important documents are? Do they have a safe deposit box?

How old is you FIL? Is he eligible for or drawing a pension or Social Security?
62. No pension. My FIL is a minister. I am trying to track down whether or not be bought in to social security or not so that might help this thread.

Carefreeap
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Location: SF Bay Area

Re: FIL Stage 4 Cancer - Next steps

Post by Carefreeap » Mon Oct 23, 2017 5:44 pm

Silk McCue wrote:
Mon Oct 23, 2017 4:31 pm
Contact the Real Estate agent and ask what happens if your FIL passes before closing. I would hope that steps can be taken now to alleviate any issue with this if it isn't already established by state law. They can certainly answer this question. A quick web search on this topic found a reference saying if the seller dies the contract is still enforced (no idea what state that was based on). Condolences.
I know this is true in CA. The seller's estate is obligated to fulfill the contractual obligation. However the reverse isn't true, that is if the buyer dies his/her estate isn't obligated to go through with the purchase. I'm assuming this is because the buyer's income would disappear and there would be no way to fulfill the ongoing costs of a purchase.

If I were the OP I'd contact an elder law attorney to assist with your FIL possible transition to Medicaid if there's not much equity in the house or savings. Where is MIL planning to live after the house sells?

TRC
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Joined: Sat Dec 20, 2008 5:38 pm

Re: FIL Stage 4 Cancer - Next steps

Post by TRC » Mon Oct 23, 2017 6:56 pm

So sorry you have to deal with this. Stating the obvious, but I would try to identify any and all assets, liabilities, monthly bills, etc. and get account #s, passwords, and beneficiaries in order.

JerLon
Posts: 133
Joined: Fri Aug 21, 2009 2:03 pm
Location: Western NY

Re: FIL Stage 4 Cancer - Next steps

Post by JerLon » Tue Oct 24, 2017 4:50 pm

Health Insurance Update:

Plan: Christian Healthcare Ministries, Gold Plan, Brothers Keeper

So, it looks like there is a $500 cap per incident (I am assuming an occurrence of cancer is an incident). No annual cap per incident (would be capped at $125,000 w/out Brother's Keeper).

Given this, is the recommendation still to join an ACA plan during open enrollment or do folks have good experiences with CHM? I know CHM will be more paperwork to process and submit claims but it seems like it might be the best financial option.

Thoughts?

Weathering
Posts: 5
Joined: Sun Oct 15, 2017 4:20 pm

Re: FIL Stage 4 Cancer - Next steps

Post by Weathering » Tue Oct 24, 2017 9:20 pm

JerLon, I may be the only one unfortunate enough to see your post on the Melanoma forum (for medical discussion) and here (for financial discussion).
With the new surgical approaches and recent immunotherapy advances your FIL could live a very long life. Asking the right financial questions is the right thing to be doing. Your hospital may also be a good source to help with additional resources available to cancer patients (clinical trials of immunotherapy provide free medications which otherwise would cost >$10K per infusion, foundations, scheduling surgery for Dec 29 or Jan 3 depending on which year is better for insurance reasons, etc).
I spend more time on the other forum so I may not see replies here.
MovingOn

Rupert
Posts: 2730
Joined: Fri Aug 17, 2012 12:01 pm

Re: FIL Stage 4 Cancer - Next steps

Post by Rupert » Wed Oct 25, 2017 7:43 am

JerLon wrote:
Tue Oct 24, 2017 4:50 pm
Health Insurance Update:

Plan: Christian Healthcare Ministries, Gold Plan, Brothers Keeper

So, it looks like there is a $500 cap per incident (I am assuming an occurrence of cancer is an incident). No annual cap per incident (would be capped at $125,000 w/out Brother's Keeper).

Given this, is the recommendation still to join an ACA plan during open enrollment or do folks have good experiences with CHM? I know CHM will be more paperwork to process and submit claims but it seems like it might be the best financial option.

Thoughts?
My thoughts are that cancer treatment today can well exceed $500,000 per incident. So unless your FIL has decided he will not seek such treatment, I'd be looking for an insurance policy that has no cap.

PoppyA
Posts: 354
Joined: Sat Oct 11, 2014 4:24 pm

Re: FIL Stage 4 Cancer - Next steps

Post by PoppyA » Wed Oct 25, 2017 7:50 am

I hate cancer. I am sorry it is throwing life into a panick like it often does.

Talk to his dr. They often have access to $ to assist.
"La Bella Luna"

furwut
Posts: 1256
Joined: Tue Jun 05, 2012 8:54 pm

Re: FIL Stage 4 Cancer - Next steps

Post by furwut » Wed Oct 25, 2017 9:05 am

JerLon wrote:
Tue Oct 24, 2017 4:50 pm
Health Insurance Update:

Plan: Christian Healthcare Ministries, Gold Plan, Brothers Keeper

So, it looks like there is a $500 cap per incident (I am assuming an occurrence of cancer is an incident). No annual cap per incident (would be capped at $125,000 w/out Brother's Keeper).

Given this, is the recommendation still to join an ACA plan during open enrollment or do folks have good experiences with CHM? I know CHM will be more paperwork to process and submit claims but it seems like it might be the best financial option.

Thoughts?
CHM is not real insurance. They have no contractual obligation to pay claims and their business is not regulated. They likely do not have agreements with many of the healthcare providers your FIL will need exposing him to ruinous up front charges or, even, refusal of care.

Repeating suggestion above - ACA now!

https://www.nytimes.com/2015/02/01/opin ... .html?_r=0

Silk McCue
Posts: 386
Joined: Thu Feb 25, 2016 7:11 pm

Re: FIL Stage 4 Cancer - Next steps

Post by Silk McCue » Wed Oct 25, 2017 9:10 am

furwut wrote:
Wed Oct 25, 2017 9:05 am
JerLon wrote:
Tue Oct 24, 2017 4:50 pm
Health Insurance Update:

Plan: Christian Healthcare Ministries, Gold Plan, Brothers Keeper

So, it looks like there is a $500 cap per incident (I am assuming an occurrence of cancer is an incident). No annual cap per incident (would be capped at $125,000 w/out Brother's Keeper).

Given this, is the recommendation still to join an ACA plan during open enrollment or do folks have good experiences with CHM? I know CHM will be more paperwork to process and submit claims but it seems like it might be the best financial option.

Thoughts?
CHM is not real insurance. They have no contractual obligation to pay claims and their business is not regulated. They likely do not have agreements with many of the healthcare providers your FIL will need exposing him to ruinous up front charges or, even, refusal of care.

Repeating suggestion above - ACA now!

https://www.nytimes.com/2015/02/01/opin ... .html?_r=0
CHM pays as agreed and has for years. Just because you don't believe it's not good doesn't mean it isn't.

Rupert
Posts: 2730
Joined: Fri Aug 17, 2012 12:01 pm

Re: FIL Stage 4 Cancer - Next steps

Post by Rupert » Wed Oct 25, 2017 9:18 am

Silk McCue wrote:
Wed Oct 25, 2017 9:10 am
furwut wrote:
Wed Oct 25, 2017 9:05 am
JerLon wrote:
Tue Oct 24, 2017 4:50 pm
Health Insurance Update:

Plan: Christian Healthcare Ministries, Gold Plan, Brothers Keeper

So, it looks like there is a $500 cap per incident (I am assuming an occurrence of cancer is an incident). No annual cap per incident (would be capped at $125,000 w/out Brother's Keeper).

Given this, is the recommendation still to join an ACA plan during open enrollment or do folks have good experiences with CHM? I know CHM will be more paperwork to process and submit claims but it seems like it might be the best financial option.

Thoughts?
CHM is not real insurance. They have no contractual obligation to pay claims and their business is not regulated. They likely do not have agreements with many of the healthcare providers your FIL will need exposing him to ruinous up front charges or, even, refusal of care.

Repeating suggestion above - ACA now!

https://www.nytimes.com/2015/02/01/opin ... .html?_r=0
CHM pays as agreed and has for years. Just because you don't believe it's not good doesn't mean it isn't.
And just because you believe it's good doesn't mean it is. This issue comes up here at Bogleheads from time to time. OP, if your FIL decides to stick with CHM, please report back to us how and what they paid, etc. It would be tremendously helpful to others who have considered going with a sharing ministry model, as opposed to traditional health insurance, but have refrained from doing so because they feared developing a very costly disease such as the disease your FIL has developed.

furwut
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Joined: Tue Jun 05, 2012 8:54 pm

Re: FIL Stage 4 Cancer - Next steps

Post by furwut » Wed Oct 25, 2017 9:18 am

CHM pays as agreed and has for years. Just because you don't believe it's not good doesn't mean it isn't.
A simple google search puts that seriously in doubt.

Red Headed Mommy
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Joined: Sun Nov 17, 2013 9:20 pm

Re: FIL Stage 4 Cancer - Next steps

Post by Red Headed Mommy » Wed Oct 25, 2017 9:27 am

So sorry your family is going through all of this…I echo the comment “I hate cancer"!

It is so kind of you to help your family through this time. Based on my own personal experience, here are a few ideas.

-Confirm that every bank account is set up with Joint Tenancy With Right of Survivorship (JTWROS). It is important that your FIL didn’t have any accounts solely in his name that would make it difficult for your mother-in-law to gain access.

-Confirm every beneficiary on any accounts (like an IRA) are current and in the manner your FIL would want.

-Make sure his will is up to date and reflects his desires. They should also have documents such as medical power of attorney and advance directives in place.

In my husband’s case as his cancer progressed, he was adamant that he would not go back to the hospital and he was cared for at home with hospice. There can be a huge financial impact on avoiding the hospital for end of life issues. I am not suggesting one way or another…it is a very personal decision, but there are financial ramifications, esp. if he is in a cost sharing plan.

-Discover if he is a participant in Social Security. Metastatic Melanoma may be a Compassionate Allowance on Social Security Disability. There are numerous requirements and waiting periods to receive the disability payment, but some diseases are “fast tracked” and decisions are made in a very timely basis without as much required paper work. Hopefully he will live a long time, and Social Security Disability would be helpful financially if he participates in Social Security.

-As others have mentioned, accessed to online accounts and passwords is critical. You may consider updating any email addresses from your FIL to your MIL now.

-You said your FIL is a minister. Depending if he is affiliated with a denomination, they may provide financial assistance to your FIL and MIL. I know the Presbyterian Church in American (PCA) Ministerial Relief Fund provides such care.

-Hopefully it is a long time down the road, but funeral costs can be a huge financial burden. There are ways to minimize those costs, and you might explore that at some time. (Frankly, I am still shocked at how crazy expensive this area is!!)

Thank you for helping your family in such a time of need...

malabargold
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Re: FIL Stage 4 Cancer - Next steps

Post by malabargold » Wed Oct 25, 2017 9:30 am

Jimmy Carter has Stage 4 melanoma, still going several years
later

Silk McCue
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Joined: Thu Feb 25, 2016 7:11 pm

Re: FIL Stage 4 Cancer - Next steps

Post by Silk McCue » Wed Oct 25, 2017 9:33 am

furwut wrote:
Wed Oct 25, 2017 9:18 am
CHM pays as agreed and has for years. Just because you don't believe it's not good doesn't mean it isn't.
A simple google search puts that seriously in doubt.
You can google "problems with Index funds" and find lots of reasons not to invest in them. You can google "should I get married" and would probably decide not to get married. You could have traditional insurance that you can't afford with a deductible that is beyond your means. Life is full of choices and everyone can be challenged in making decisions but CHM and Medishare are viable options for those that understand the strengths and weaknesses associated with them. Just like the strengths and weaknesses of traditional insurance.

JerLon
Posts: 133
Joined: Fri Aug 21, 2009 2:03 pm
Location: Western NY

Re: FIL Stage 4 Cancer - Next steps

Post by JerLon » Wed Oct 25, 2017 3:22 pm

Thank you all for the great advice.

Does anyone have any information or good resources for the potential for SSI Disability given a diagnosis of Metastatic Melanoma?

Silk McCue
Posts: 386
Joined: Thu Feb 25, 2016 7:11 pm

Re: FIL Stage 4 Cancer - Next steps

Post by Silk McCue » Wed Oct 25, 2017 3:47 pm

JerLon wrote:
Wed Oct 25, 2017 3:22 pm
Thank you all for the great advice.

Does anyone have any information or good resources for the potential for SSI Disability given a diagnosis of Metastatic Melanoma?
Please take a look at the following.

https://www.disabilitybenefitscenter.or ... metastases

JerLon
Posts: 133
Joined: Fri Aug 21, 2009 2:03 pm
Location: Western NY

Re: FIL Stage 4 Cancer - Next steps

Post by JerLon » Wed Oct 25, 2017 4:10 pm

Silk McCue wrote:
Wed Oct 25, 2017 3:47 pm
JerLon wrote:
Wed Oct 25, 2017 3:22 pm
Thank you all for the great advice.

Does anyone have any information or good resources for the potential for SSI Disability given a diagnosis of Metastatic Melanoma?
Please take a look at the following.

https://www.disabilitybenefitscenter.or ... metastases
Yes, unfortunately not about metastatic melanoma. I have completed a number of web searches without much success on the prospects of SSI disability (specifically compassionate allowance) with metastatic melanoma.
Last edited by JerLon on Wed Oct 25, 2017 4:25 pm, edited 1 time in total.

Silk McCue
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Re: FIL Stage 4 Cancer - Next steps

Post by Silk McCue » Wed Oct 25, 2017 4:20 pm

Deleted

Red Headed Mommy
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Re: FIL Stage 4 Cancer - Next steps

Post by Red Headed Mommy » Wed Oct 25, 2017 8:31 pm

https://secure.ssa.gov/poms.nsf/lnx/0423022810

Here is the link to the Social Security website Program Operations Manual that lists DI 23022.810 Skin Malignant Melanoma with Metastases as a compassionate allowance...maybe this is different than your FIL diagnosis...

wcshaff
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Re: FIL Stage 4 Cancer - Next steps

Post by wcshaff » Wed Oct 25, 2017 8:55 pm

I am a survivor of Melanoma. It was likely a result of an experimental vaccine trial that I participated in at National Cancer Institute at NIH in Bethesda. The lead researcher was then and continues to be Dr. Steven Rosenberg. He is the unquestioned leader on Melanoma. His team has moved into gene therapy with surprising results. This was profiled in the book "The Emperor of All Maladies" (and the PBS series that was based on the book). I would strongly suggest that you contact NIH and see if there is a trial that might be a fit. I would note that some of these therapies require certain characteristics in the patient - for example, blood typing.

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