Most of us usually rely on the experience of others to understand how to deal with similar situations. The real problem with this is that benefits are person-centered. Benefit programs fit each individual differently, based on a variety of facts and conditions, such as:

Because there are so many issues when starting a new job, you may not realize the critical need to enroll in benefits during the initial enrollment period. If you have a new diagnosis considered to be a pre-existing condition, the initial enrollment period is the time you can enroll in group coverage without a review of your medical record. Although your pre-existing condition may not be immediately covered, the initial enrollment period allows you to enroll in group coverage.

In the state of California, there are no laws that require employers to provide benefits to employees. Employers sometimes provide individual coverage, not group plans. Individual and group benefits plans have different rules. The problem with individual coverage plans is that they usually require a review of medical records or history (called medical underwriting) for enrollment. With medical underwriting, coverage can be denied because of pre-existing medical conditions.

Employer-sponsored health coverage or other benefits should not affect your continued eligibility for Medi-Cal, Medicare and/or In-Home Supportive Services. You can access employer and public benefits together in many cases and in many ways. For example, adding employer-sponsored health coverage to public health coverage (Medi-Cal and Medicare) may enable you to have greater overall coverage increasing access to more medical providers. Also, adding public health coverage to employer-sponsored health coverage may increase access to specific prescription drugs, or personal assistance services.

Many individuals deny themselves access to benefits because they are convinced their condition makes them ineligible for coverage. What they do not know is that, with group coverage, they can enroll during the initial enrollment even with a pre-existing medical condition. If there is a pre-existing medical condition, they will need to be covered for a specified period of time before they will have the coverage available to them.

A common example: many individuals enroll in Medi-Cal and drop private health insurance because they can not pay the private health premiums. They do not know that Medi-Cal has a premium payment program for private coverage that they may be eligible for, allowing them to keep and continue with Medi-Cal and the private coverage. Before dropping or denying any coverage, it is best to review all your benefit choices. There may be multiple solutions to resolve benefits issues. Some individuals will make benefit choices without a well thought out plan taking into account all options available.

Many state and federal programs require strict medical or financial need and long application procedures before they provide benefits or services. Understanding how to access employer-sponsored benefits and public programs such as health coverage, wage replacement or income coverage, can reduce, minimize or delay poverty caused by disability.

The more specifically you document your medical condition, the easier it will be to support a claim and to make a case for continuing benefits. Detailing in a daily journal even the most seemingly insignificant symptoms can be of great value. If you or the individual are too ill, or can't maintain the journal on a daily basis, a friend or relative can log the entries. This journal can also provide you with a way to inform providers about your medical condition.