What to do if the coronavirus affects your job or finances

Breast Cancer News
April 17, 2020

COVID-19, the disease caused by the new coronavirus, has forced most Americans to stay home, slowing the spread of the disease but causing millions of people to lose their jobs or health insurance. Whether you are one of the newly unemployed or underemployed or want to take action now to be prepared, it’s important to know where to turn for assistance and what has changed since the outbreak. We’re here to help.

Living Beyond Breast Cancer CEO Jean Sachs, MSS, MLSP, spoke to Monica Bryant, Esq, of Triage Cancer about financial questions relating to COVID-19: What to do if you lose your job, what to prepare in case you get sick, tips for making sure your needs are met when you’ve lost income, and more. Watch, listen, or read the transcript below.

Triage Cancer is also hosting a free webinar, in partnership with AOSW, on April 21, 2020: Key Changes to Insurance, Finances, & Work During COVID-19.

Monica Fawzy Bryant, Esq
Monica is a cancer rights attorney, speaker, and author, dedicated to improving access to, and availability of, quality information on healthcare-related issues. She is the co-founder and chief operating officer for Triage Cancer, a national nonprofit organization that provides education on the practical and legal issues that may impact individuals diagnosed with cancer and their caregivers. Read more. 

 

Jean A. Sachs, MSS, MLSP
Chief Executive Officer, Living Beyond Breast Cancer
Jean began her work with LBBC in 1996 when she became the organization’s first executive director; she was named CEO in 2008. Jean brings a lifetime of women’s advocacy experience to her role as CEO. She lives LBBC’s mission everyday by speaking with newly diagnosed women about their needs and gaps in support. Read more.

 

Jean Sachs:

Hi everyone. It's Jean Sachs. I'm the CEO of Living Beyond Breast Cancer and I am coming to you once again to provide up-to-date information on what cancer patients are facing during this pandemic. I am really pleased that today I have Monica Bryant who is a cancer rights attorney and the co-founder of Triage Cancer. If you haven't been on Triage Cancer's website, I really encourage you to take a look. They have a lot of resources, a lot of infographics and videos, and it's chockfull of information.

We've been working with Triage Cancer for many years and really view them as one of our key partners. Welcome, Monica.

Monica Bryant:

Thanks so much for having me.

Jean Sachs:

Knowing that everything is rapidly changing, we know you can only answer these questions to the best of your knowledge today. That's what we're asking you to do and we might have to bring you back in 2 weeks and get an update.

Why don't you start by sharing the top three questions that people with cancer are asking Triage Cancer right now about the impact of the coronavirus on their finances.

Monica Bryant:

People are struggling, trying to decipher and translate what they're hearing in the news, be that cable news or social media or from friends and family. There's a lot of information. It's coming quickly. We have a couple of new pieces of law that people are trying to decipher and figure out what it means for them. We have a new paid sick leave benefit. We have new family medical leave benefits. We have cash payments that are coming out. People are really trying to figure out what is relevant to them and what benefits they have access to.

Jean Sachs:

We'll talk about these various benefits, but let's just start with unemployment. We know unemployment rates are higher than they have been in many, many decades. If someone loses their job, what should they do right away? What's the first thing?

Monica Bryant:

We have over 22 million people now filing for unemployment, which is astronomical. Every state's unemployment process is a little bit different, but generally speaking, individuals who have been employed have access to unemployment benefits while they're searching for a new job.

There has been recent federal legislation that's actually expanded those state benefits and it's expanded in in a couple of ways. The first is that it's given access to unemployment benefits to a new category of employees, we're talking about people who are self-employed or independent contractors or gig workers. Typically those individuals didn't have access to unemployment benefits. This new legislation now gives them access. It is trying to increase the benefits for individuals who have access to unemployment benefits.

Jean Sachs:

If you need to sign up, do you get on the phone? Do you get online? What's the step?

Monica Bryant:

That’s one of the tricky things given the volume of people who are now applying for unemployment. The unemployment offices really have been inundated. They need to contact their state unemployment agency and you can typically do that over the phone or online. We have heard anecdotally that there are certain times of day that might be better to call the office, but really across the board it's going to take a little bit of perseverance.

Jean Sachs:

Are you going to tell us those times?

Monica Bryant:

Well, one for example, I was recently on the phone with somebody who said that they were able to get through at 3:00 a.m.

Jean Sachs:

The workers are really putting in the hours to try to process these claims.

Monica Bryant:

Absolutely. I don't think it's for lack of trying, I really think it's just a volume situation. Unemployment agencies really weren't set up to take 22 million claims in a 4-week period. We're in unchartered waters here.

Jean Sachs:

Once you've applied, how long does it take until you get your first check?

Monica Bryant:

It really is going to depend state by state. There is some ability in certain states to have retroactive benefits going to the beginning of April for some of those independent contractors, then the benefits can be retroactive up until January. It's going to depend a little bit based on what somebody's situation is, but again, the faster you apply, the faster you'll get benefits.

Jean Sachs

Monica, what if someone's lost their health insurance?

Monica Bryant:

Well, the reality is that over half of Americans get their insurance through their employer. If they've now lost their job, they could also be faced with losing their health insurance. And the good news is there's probably several different options.

COBRA is the federal law that allows certain employees to keep their health insurance when they would normally lose it. If they've left their job entirely or they've reduced their hours from full time for part time, which now means that they're not eligible for benefits, they could be eligible for COBRA. Now, COBRA is only available if the employer has 20 or more employees. That could be an issue.

If somebody works for a smaller employer, then they may want to be looking at their state COBRA law. The reason for that is that the state laws are actually going to cover those smaller employers with less than 20 employees.

COBRA is really helpful in a lot of situations because it's the exact same health insurance — it's the same doctors, the same network, the same out-of-pocket payments. The downside is that once someone elects COBRA, they're now responsible for 100 percent of that premium, plus sometimes a 2 percent administrative fee. So it can be very expensive to keep COBRA, but it could again be very worthwhile to them.

Another option, if someone's losing their employer-sponsored insurance is they may be eligible for a special enrollment period through their state health insurance marketplaces. This would be an opportunity for somebody to go in and find a totally new plan through the state marketplace. They have 60 days from the time they lose their employer coverage to buy a new plan. The benefit of looking at the marketplaces is now, based on somebody's current financial situation, having lost their jobs, they may be eligible for some financial assistance to buy those plans in the marketplace. The other thing about marketplace coverage is it could be as good, if not better than what somebody had is from an employer.

What we typically say, anytime somebody is losing their employer sponsored coverage is they have to look at all their options: COBRA and the marketplace and maybe they're eligible to go on another group plan, like a spouse's plan or, if they're under the age of 26, a parent's plan. Then they have to do the math in order to figure out which is really going to be the best plan for them.

We have resources at triagecancer.org about how to pick a plan and how to do the math so that people can pick the most affordable and adequate plan for them.

Jean Sachs:

A lot of research that you might need to do. If you are let go, let's say on April 7, will your health insurance still be good for that month?

Monica Bryant:

It really depends on the employer. Some employers will terminate the policy on the date of termination, so your policy ends April 7. Some will say your policy goes till the end of the month. Some employers will even say we'll give you insurance for 3 more months. It really is going to depend on the specific employer and that's definitely a question that somebody should be asking when they are let go.

Jean Sachs:

And along the same lines, we're hearing a lot about workers being furloughed. If you were furloughed, is it possible that your health insurance will stay in?

Monica Bryant:

Yes, that is absolutely a possibility. It's not a guarantee. Again, that would be a question to ask when somebody gets furloughed to figure out, what is happening with their health insurance?

The other piece of it is: with an employer sponsored insurance, typically the employer pays a portion of the premium and the employee pays a portion of the premium and the employee's portion just comes straight out of the paycheck. Well, if they're not getting a paycheck every month, how was that employee portion being handled? Even if somebody is being furloughed and the employer says, yes, your health insurance will stay intact, we will continue to provide health insurance. The next question needs to be how do I pay my portion of the premium? I know it's a lot of steps.

Jean Sachs:

If you're going to shop in the marketplace, what is that website that people should look at?

Monica Bryant:

Everybody can start at healthcare.gov. There are a handful of States that run their own marketplaces, but if you start at healthcare.gov and you pick your state, if you're in one of those states, like California for example, the website will actually kick you over to Covered California, the state place. But everybody can start at healthcare.gov.

Jean Sachs:

That's great. Let's move on to basic expenses. If you've lost your job, maybe you don't have a lot of savings or you have a month of savings. What are some strategies people can take to manage their day-to-day finances? They need foods, they need to cover their bills, their utilities. Obviously their phone, their internet has become so important.

Monica Bryant:

Fortunately, there have been a lot of developments to help people deal with these day-to-day expenses. For example, mortgage companies and student loan companies have agreed to defer or delay payments. There have been many different things happening in states where evictions have been stopped for the time being. There are so many things that are happening and some of them are state specific, some of them are city specific.

At triagecancer.org, on our blog, we've actually laid out many of these different options, from food assistance to affordable utilities to these mortgage company programs and student loan companies programs. I would definitely recommend taking a look at that.

There are also some financial assistance options that are available, even pre-coronavirus, through the cancer community. State, county, local organizations, certainly cancer community organizations. The pharmaceutical companies have lots of programs.

And generally speaking, when we're talking about the financial assistance piece, people have to be creative. What I mean by that is sometimes people can get tunnel vision and they'll come to us and they'll say I can't pay for my prescription drugs and I can't get prescription drug assistance. I don't meet those qualifications. What do I do? Then I say something to the effect of, do you have money set aside for your utilities? Well, yes I do. Okay, let's see if you can get you utility assistance so then we can shift those funds over to paying for your prescription drugs. Fill in the blank with any example there. But it's easy in the stress and the anxiety and this is also overwhelming to get that tunnel vision. And unfortunately we find that people really have to just take a step back and figure out how they can play a little bit of rearranging to figure out how they can get all of their needs met.

I will also say that one of the pieces of legislation that was passed recently was the economic stimulus payments. Those are the $1,200 payments that should be coming to most people. It is based on income, so as long as you make under a certain amount, you should be getting $1,200 for each adult individual in your households and up to $500 for children up to the age of 16.

Jean Sachs:

Yeah, we have heard about that. If you are someone that is on disability or SSI [Social Security Insurance] disability, you don't have an income, are you eligible for that stimulus package?

Monica Bryant:

Yes. You are definitely eligible. Though one of the sticking points has been that those individuals typically don't file taxes annually, because their income doesn't meet the thresholds to require them to file taxes. And there has been a lot of back and forth about do those individuals who are receiving either SSI or SSDI, the Social Security Administration or even social security retirement, do they have to now go rush to file their taxes in order to get these payments and the latest news — and I say that with my asterisk — that those individuals do not need to do anything extra, that the funds will be deposited into the account that their normal benefits are deposited into.

The only caveat to that is, if somebody does have a child under the age of 16, in order for them to get that additional $500, they do have to go to the IRS website and fill out a form.

Jean Sachs:

That's really helpful because that has been a question we've gotten for a number of people. Let's switch to how cancer treatment is being impacted by COVID-19. We know that, for many women, procedures are being delayed or maybe the guidelines that were in place are being changed to keep people out of the hospital and minimize hospital stays. Should anyone be worried that their insurance won't cover their treatment if their treatment plan changed because of this?

Monica Bryant:

If the insurance policy was to cover that treatment irrespective of COVID-19, then they shouldn't be worried that just because there's now been a delay that it won't be covered.

One example that we've been hearing is women who have completed their treatment for breast cancer and now we're scheduled to go have the reconstruction and their reconstruction is now being considered “elective” and it's being pushed off. The good news is, is that there's actually a federal law, the Women's Health Cancer Rights Act, or WHCRA, that requires insurance companies to cover the reconstruction if they cover the original mastectomy. And that doesn't change because the reconstruction is now happening later than when it was originally planned. Especially because the delay in treatment is for a medical reason, in that it is actually to people's benefit to be staying out of hospitals right now.

I will say that if people are having a hard time with their insurance companies or their insurance companies are saying that they're not going to cover particular services because there's been a delay, then that is a prime opportunity to take advantage of the appeals process and we have a wealth of information, both a quick guide and an hour-long webinar on the Triage Cancer website about how to navigate that appeals process.

Jean Sachs:

Your website has a lot of information. Monica, if you could just talk a little bit about what documents women should have in order, particularly because we are all living through this pandemic and it's a time to just make sure everybody knows where your paperwork is. What are the key things we need to have in order?

Monica Bryant:

I'm a huge proponent of estate planning and I think it's so incredibly important for everybody to have some basic documents in place. That includes a will. A will is a legal document that allows us to indicate what we want to have happen to our property if we were to pass away. It's also where we're able to name guardians for minor children. Wills are incredibly important to have. Every state's a little bit different in terms of the exact requirements, but in most states, a simple will form can be filled out.

The other documents are power of attorneys. There's a power of attorney for financial affairs and this is an individual that you would name to be able to make financial decisions for you. That could be anything from paying the cable bill to negotiating a payment with a hospital to writing checks out of your bank account.

They can be very, very broad, they can be pretty narrow, but it's important. Let's say the worst case scenario is you're in the hospital for a few weeks. Who's going to take care of all of those financial and business pieces of your life?

Then the advanced healthcare directives are important. An advanced healthcare directive is actually a couple of different things. It's a place for people to write down their wishes for what they want to have happen to their medical care if they're unable to speak or communicate. That could be anything from artificial hydration and nutrition to pain management to use of a ventilator. So those are all the kinds of things that you could talk about in an advanced directive. Also in an advanced directive, you're able to name an agent or a power of attorney to make healthcare-related decisions. Sometimes for people, these agents are the same person. Your power of attorney for finances, it's going to be the same person that makes your medical decisions. For some people it's very different agents and it absolutely can be. There's nothing that says it always has to be the same person.

I recommend that everybody has these in place all the time, but of course it's certainly more important now that we are all living through this.

Jean Sachs:

Everything is shut down in most of, well in all of the country right now. Is it possible to get to fill out these documents and can you do it on your own or do you need an attorney to walk you through it?

Monica Bryant:

For most simple wills, and certainly advanced healthcare directives, you do not need to have an attorney create them for you. Many, many states have a fill-in-the-blank version, for lack of a better phrase, and those can be found on our website. But if you Google your state and your state bar association, you are probably going to be able to find the form to download.

The practical issue comes in that in order to create a valid will and a valid advanced healthcare directive, you actually have to have either one or two, depending on the state, disinterested witnesses. That means that it can't be somebody who's named in your will or it can't be a direct family member. Well, we're all stuck at home with our direction family members, so it creates a real, practical problem for the witnessing portion.

At Triage Cancer we've been frantically trying to do the research to figure out what states are doing to address this. And many states have either passed executive orders or have laws in place to allow for remote witnessing. Get on a Zoom chat, do something like this, for electronic witnessing. I know some estate planning attorneys here in Chicago that are doing drive by, so you literally drive by their house and put your paper out the window and sign it. People are getting really creative. Obviously this is an area where the law is running behind the reality, but I would say stay tuned and take a look at the Triage Cancer blog for more updates about what's happening in each state.

Jean Sachs:

That's helpful. And also make sure people know where your documents are.

Monica Bryant:

One hundred percent. And not just that you know where your document is, but that your agents know where your documents are.

Actually that brings up some really practical pieces to all of this. We've been asked recently, “What do I do if I get taken to the hospital and my loved one can't come with me? How is the healthcare team going to know that I have an advanced directive?”

There's a couple of ways to address this. You could carry a hard copy with you at all times. That's probably less practical. You could also have an electronic version. For example, all of my estate-planning documents are saved on a Google drive. Then my agents have the link to those documents so anywhere in the world, as long as somebody has a phone or a computer, they can access my documents. And that can also be really helpful if an agent needs to communicate with the healthcare team but can't physically enter the healthcare facility, which is a real practical issue right now. Those documents could get emailed to the healthcare team.

Jean Sachs:

Yeah, and I've heard that the healthcare professionals are just doing a really good job of trying to reach out to people and stand in and help out.

Monica Bryant:

Absolutely. They're certainly doing their best and I think anything that we as healthcare consumers at the moment can do to make their job easier is a good thing.

The other interesting thing I thought of the other day, many of us have smartphones now and I know certainly Apple iPhones and Android phones have an ability to put in an emergency contact in your phone that's accessible to first responders, even if they can't unlock your phone. That's something that's a place where somebody could put that this is my emergency contact and I have an advanced healthcare directive so that providers know that they need to contact that emergency contact to get more information.

Jean Sachs:

That's really helpful and this is a good time to figure out how technology can really be our friend.

Monica Bryant:

Absolutely. And I think we are all we are. It's a steep learning curve.

Jean Sachs:

Monica, thank you so much. This has been incredibly informative and I really appreciate you giving your time, I know you have your kids at home and a lot of things that you're balancing.

But for everyone out there and know that Triage Cancer is a great resource. Go on their website, you'll be able to get a lot of information. And of course Living Beyond Breast Cancer, we are continuing to create content every week. We have several closed Facebook pages, one that is for all stages and all ages and one that is for young women. So if you want to connect, let us know. We also have a Helpline, so we will continue to be here for as long as we need to, and we just hope that you all stay well and healthy and strong.