The Benefits Decisions That Held When Everything Else Fell Apart

Stage IV cancer has a sneaky way of showing up. It becomes that stage because you don't know it's there. In the fall of 2025, I had no idea melanoma was wreaking havoc on my body, yet it was during that time that I made some really good decisions. Decisions that, had I not made them, might have me writing a very different post right now.

Most people treat open enrollment like a formality. You click through the screens, keep what you had last year, skip the "extras" that feel like a gamble, and move on. I get it. I've been there. But getting a cancer diagnosis at 29, while pregnant with your first child, has a way of changing how you look at a benefits packet. I knew what it felt like to get that news. I knew the last thing you want to do in a hospital bed is wonder whether you're covered.

So when open enrollment came around again in late 2025, I paid attention. And when December brought a stage IV melanoma diagnosis, a return of the disease I thought surgery had resolved back in 2019, those decisions held.

When the diagnosis came back

For the first few weeks after my diagnosis, I'll be honest: I was still thinking about work. Deadlines. My team. The weight I was about to drop on people who depended on me. I am an ambitious woman who loved her very stressful job, and it took my body forcing the issue before I fully let go.

The symptoms intensified. I couldn't go in due to pain, and somewhere in that blur, I stopped caring about my email. I stopped canceling appointments. I had about two weeks of paid sick time accrued, and beyond that, I had no idea what would happen. What I didn't know yet was that a few clicks on the last day of open enrollment had already built the floor I was about to fall onto.

FMLA: the protection I didn't have to elect

Around the time my sick time ran out, I was admitted to the hospital. I'd stay for almost four weeks.

My husband had to gather paperwork to request leave under the Family and Medical Leave Act (FMLA), a federal protection that keeps your job for up to 12 weeks when a serious health condition takes you out of work. This one wasn't something I elected during open enrollment; it's a federal entitlement. But there's a catch good to have on your radar: you have to have worked for your employer for at least one year to qualify. I had. That detail mattered more than I ever expected it to.

FMLA protects your job. It does not pay you.

Short-term disability: the decision I almost didn't make

That's where short-term disability came in. Short-term disability is an employer-offered benefit that replaces a portion of your income when a medical condition prevents you from working, and it's one you typically have to elect during open enrollment.

I had elected it at the maximum benefit: two-thirds of my gross pay, for the maximum available length of time. I can credit having two kids for knowing enough about short-term disability to take it seriously. The other option had been half my pay. I chose the higher coverage, and six months into this, I'm still receiving those benefits.

That single checkbox has been one of the most consequential financial decisions of my life.

Critical illness and catastrophic leave: the lump sums that showed up immediately

Two other benefits I'd elected hit differently because of their timing. They paid out fast, right when the financial shock was sharpest.

The first was critical illness insurance, provided through Voya Financial. Upon reviewing my medical records and application, $15,000 was deposited directly into my checking account. The purpose of this benefit is to immediately offset costs that stem from a serious diagnosis: medical bills, lost income, whatever you need it for. I want to say it was the easiest $15,000 I ever made, but that would mean forgetting the month-long hospital stay and the stage IV diagnosis, so I'll take that back.

The second was a catastrophic illness leave bank offered through my employer. In exchange for two donated sick days and a 30-day waiting period, I received a payment equal to one month of my gross pay. Both of these were low-cost benefits with high-reward potential, the kind that feel unnecessary until suddenly they're the only thing standing between your family and a financial crisis.

My employer also offered a hospitalization payout benefit that I did not elect. I wish I had.

Long-term disability: the benefit I never thought I'd need

Long-term disability insurance picks up where short-term disability leaves off. My employer pays this premium fully, which I'd always noted as a nice detail without ever thinking I'd use it.

As I approach the end of my short-term disability period, I'm looking at needing it. Not because I wanted this. Because between active treatment and the physical limitations that come with it, I can't carry out the duties of my job right now. Long-term disability will pay 50% of my gross pay for as long as I need it.

When my doctor confirmed I'd need to apply, I had a moment of panic. I hadn't thought to ask about taxes yet. If you find yourself in a position of needing to use your long-term disability insurance, consider consulting a tax professional so that you avoid any surprises when tax season rolls around.

What I'd tell you before your next open enrollment

I don't know yet what my future looks like in terms of returning to work. What I do know is that if and when I sit through open enrollment again, there are benefits I will never skip, while hoping with everything I have that I never need them again.

If yours is coming up, pause on the extras. Really look at them. Critical illness coverage, catastrophic leave banks, short and long-term disability at the maximum amounts: these aren't upsells. They're the decisions that hold when everything else falls apart.