Before starting to read the below story, I ask that everyone position themselves to catch your jaws in case they drop.
In 2010 while driving home from a work meeting in Hamilton, Ontario I experienced a disabling stroke and at no fault of my own.
I received excellent acute or initial treatment and rehab while in hospital and rehab hospital.
After five months I was discharged home and still needed more rehab but was denied such publicly funded services because of my age of 55. To this day, Ontario still has major restrictions on publicly funded services available to stroke survivors.
In March, 2010 my employer immediately placed me on Short Term Disability to provide some limited income replacement and access to my health benefits. By August of 2010 I was placed on Long Term Disability (LTD) to again provide some limited income replacement and access to employer health benefits.
Because our provincial healthcare system abandoned me, I relied heavily on my employer’s health benefits to purchase private and expensive stroke recovery programs. These programs helped to achieve some very limited recovery. I still have no use of my left arm and hand. Limited walking is a challenge with a quad cane! Overall mobility remains a challenge!
“After being on LTD for two years, my employer’s health benefits were automatically terminated in 2012 and in accordance with Policy provisions.
Because I was on the Family Plan this meant that my wife, dependent children and I lost access to insured dental and eye care, medications and other benefits with my employer’s Plan. In 2012 I was forced to purchase my own Family Health Benefits Plan at an approximate cost of $7,800 per year. Fortunately, my children were still at University and they signed onto their Institution’s Health Plans.
I no longer have this private Health Plan as the rising costs were unaffordable and it made no sense once I turned age 65. Ontario has the Trillium Medications Program with a $100.00 deductible each year for seniors aged 65 and older.
When I and my family lost employer health insurance coverage while on LTD I felt really let down and disappointed by my profession.
Everyone should approach their HR Manager and investigate if your Health Benefits are automatically terminated after being on LTD for two years. Don’t be surprised by the answers, especially if you are in the private sector.
If your health benefits are terminated while on LTD you should talk to your lawyer about the merits of suing the Insurance company and your employer to have them reinstated. I wish I had undertaken such a discussion back in 2012.
Your children and spouse need help with the breadwinner off work and they should not be punished medically with denied health benefits.
My stroke took place at age 55 and I’m now age 70. If my stroke had taken place at age 35, by 37 my spouse, children and I would have lost our employer health benefits.
My message to working Canadians is simple:
“Check the fine print in your employer health plans, especially related to Long Term Disability and make sure you always have $250,000.00 in your Savings Account or Critical Illness Insurance for this amount, in case of a disabling stroke. Most employer critical illness plans are totally inadequate in case of a major medical event and one should look to purchase additional Critical Illness Insurance.
You never know how good your insurance is until you need it, as I learned back in 2012!
According to my research LTD Health Plans are available from the Insurance industry for employees up to age 65. The private sector needs the will to provide these proper plans for its employees.
Proper LTD health plans are available from insurance companies, but the private sector is too cheap to provide same for their employees.
In Ontario stroke survivors between ages 20 and 64 do not qualify for more OHIP funded treatment/rehab after receiving their initial and time limited treatment/rehab regime? Canadians need proper employer health benefits, to fill the gaps in public healthcare.
Before accepting new employment always check for such deficiencies in employer health insurance!
The sad part is that most Canadians are unaware of the deficiencies in their employer health benefits as described above!
Jim McEwen, B.Eng., retired, 70-year-old stroke survivor,
Bowmanville, Ontario, Canada, L1C6W9
Comments