Terminal husband's callousness leaves wife unprepared

Dear Bruce: My husband was diagnosed with Stage 4 incurable cancer. He is receiving radiation and chemotherapy, but the doctor informed him to get his affairs in order, as, if this doesn’t work, he has six months to live. He has not wanted to talk, and getting the information I finally got from him was like pulling teeth. I found out he let his life insurance lapse four years ago, has no health insurance and took out a loan on his house that was paid for. The reason I say “his” paid-for house is that the house was left only to him when his father passed away. Would I be better off right now filing for divorce, or should I stay, file for bankruptcy, not include the house and the car, live in the house for a while, sell it and then move into an apartment? I told him he has left me in a very bad spot if something should happen to him. His reply was, “So what, I won’t have to worry about it.” I would appreciate your honest opinion on what I should do. – Cynthia, via e-mail

Dear Cynthia: You certainly have a full plate. While it might be charitable to put the blame on your husband’s condition, it would seem that well before he was diagnosed with cancer he was, at the very least, inconsiderate in allowing his insurance to lapse, having no health insurance and borrowing without your knowledge. Before you do anything else, you should immediately see an attorney and determine what your best course of action will be. You have not mentioned whether he has a will, but it may be that a divorce might offer you some degree of protection. Please don’t do anything until you have an attorney quickly review your situation. While it might be observed that his sensibilities should receive some consideration, his reply you mentioned in the last line in your note relieves you of that responsibility.

Dear Bruce: Since I have no health insurance, I only go to the doctor when absolutely necessary. I was astounded by a new practice that I encountered recently. Besides the ridiculous fee ($231 for a consultation), I received a bill from an accounting firm for making out my doctor’s bill. I have to pay money to pay money! How long has this been going on? No wonder insurance rates are so high. – P.H., Moline, Ill.

Dear P.H.: When one doesn’t use a service regularly, the cost of the service can seem “ridiculously high.” Whether this was a valid fee is another question. The physician can assess charges he agrees to on a cash basis, but these charges should be spelled out in advance. You should know that insurance companies negotiate special deals, which often are less than the individual will pay. The most telling line in your note was that because you don’t have health insurance, you go to doctors as seldom as possible. This is one of the flaws in the third-party pay systems – if people have insurance they are inclined to go, but if they don’t have insurance, they will “tough it out.” This is why I have been an advocate of some type of copay in insurance to make people at least aware that there are costs involved. The lack of these personal responsibilities, I believe, contributes to the high cost of medical care. One final point; while there’s a significant dollar cost, we should be very grateful for the quality of care that is currently available.

Dear Bruce: My wife, 72, and I, 75, have a total annual income of around $19,000, plus a required minimum distribution of around $2,100, from our combined IRA’s, of just over $50,000. Our home is fully paid for and has a value of around $150,000. We have lived in it since 1990. We have no debts, and about $19,000 in savings plus stocks valued at around $12,000. At this point in time I see no reason to sell any of the stocks, in view of the depressed market. The reason I’m asking your advice is that I have been diagnosed with terminal cancer, and I would like to make sure that my (very healthy) wife will have the minimum of worries upon my demise. She loves the neighborhood where we live in our four-bedroom house, and has so far turned down any suggestions of selling, reverse mortgage and/or a home equity loan. Keep in mind that the $19,000 that we now receive is the total of Social Security plus Dutch Social Security, none of which is taxed. Should you need any additional information please let me know. – W.S., via e-mail

Dear W.S.: Allow me to offer my condolences on your medical condition. There are a couple of unknowns here. How much of your $19,000 will be reduced upon your demise? You haven’t given me any notion as to what the expenses are to keep the house going – taxes, insurance, maintenance, utilities, etc. It may be that, realistically, a four-bedroom home is just beyond your wife’s ability to handle. I think you have to give her a reality check. I would not be in favor of a home equity loan. A reverse mortgage could work, given the fact that your wife would receive income and could always live there as long as she could pay the taxes, insurance and upkeep. Selling may be a viable option but that’s between you and your spouse. You’ll have to pull together all these strings to come up with reasonable alternatives. After getting all of this together, I will do my best to help out if you want to drop me a note.

Dear Bruce: Do you consider nursing home insurance a smart buy? I am hearing a lot of conflicting information. Should I consider purchasing it at 40 years old or my dad purchasing it at 60? My dad and I discussed this, and he is afraid that he or my mom will have to go to a nursing home and all of their hard-earned savings will be forfeited to pay for it. It would be great to give him some peace of mind. – Reader, via e-mail

Dear Reader: While you’re far too young to think about nursing home insurance, your dad is another story. Assuming that he is trying to preserve his assets, a nursing home policy may very well give him the peace of mind that he requires. In today’s world, you can consider nursing home costs to be somewhere in the neighborhood of $40,000 a year per person, and I would want a minimum of five years’ protection.

Dear Bruce: I have been under the impression that Medicare is a benefit for retired or disabled people receiving Social Security benefits. Since we pay premiums, copayments and deductibles like other medical insurance plans, I thought our accounts were zeroed-out on an annual basis.

Recently, I have heard that Medicare is suing some folks’ estates apparently to recoup some, or all, of the expenditures Medicare made for treatments during their lifetimes. Is this true, and what determines whether an estate is liable for such posthumous lawsuits? – L.D., via e-mail

Dear L.D.: I think you are confusing Medicare and Medicaid. Medicare is an insurance that you are paying for throughout your working life, and there is no recapture. Medicaid is welfare run by the states. If money is paid out on a Medicaid beneficiary and it turns up under investigation that there is property or assets that can be attached to help recapture some of the benefit, the states will do so. Your Medicare benefits are not recoverable by any agency as long as there is no fraud.

Bruce Williams is a national radio talk show host and syndicated columnist.