My health insurance got cancelled without me knowing, what rights do I have?

Question

I've had my insuance through my employer from october of '06. Money has been taken out of every paycheck to pay for the premium. I recently had an accident that required surgery and hospital stay in late feb. I have received three explanation of benefits from the insurance provider so far: 1.) for my ambulance ride which was covered. 2.) The first couple days with services shown as "Inpatient" and "Ancillary" which was covered. 3.) and a third peice of paper for the remainder of my stay for "SNFINPT" and "SNFANCIL" as the services provided but the third peice of paper states that I may be responsible for the bill because my membership was terminated prior to the date of service.

I never received or heard anything from my employer or my insurance provider about my coverage being cancelled but my paycheck shows money being taken out for the premium up until the time of the injury. What rights do I have so I'm not stuck with this ridiculous bill? Any help would be great!

Answer 1

Start with your HR person. Sometimes errors are made - either the premium payment was late and the entire company got cancelled - it's a HUGE pain in the neck, but it does happen. OR someone who's info is similar to yours was supposed to be cancelled, and they canceled you by mistake.

As long as you can document (via your pay stubs) that you were paying your premiums, you have every reason to believe that you have coverage. Therefore, it was probably someone's mistake, and it needs to be rectified ASAP.

BTW - contact the provider of service - the hospital and/or doctors to let them know you're fighting this so they don't think you're ignoring the bills.

Answer 2

Well, first of all, call the insurance company or the Human Resources of your company that you work for.

Based on the information provided, it may the SNF - Skilled Nursing Facility benefit that may not be covered under your current group certificate.

Each year, your employer works with various insurance companies in order to get the best rate for the company, and sometimes in order to get a lower rate, they may drop some benefits, you can appeal to the insurance company.

Sorry for your chaos, and hope you are recovering well...

Answer 3

Did your employment terminate prior to the date of service? If you're still employed, you'll likely need a lawyer to sue for employment benefits liability - they forgot to pay the insurance company. Of course, if you sue your employer for that, you'll be fired, no doubt.

But if your employment terminated prior to the service date, and your employer isn't subject to the Cobra laws (namely, it's a small outfit) then you owe the money.

Answer 4

As an corporation I even have paid for wellness care out of my own pocket for one among my workers by way of fact I had inadvertantly enable her coverage lapse and that i felt it basically ultimate that I gain this. you ought to ask your corporation if he will conceal the expenditures that would desire to routinely have been paid for by way of the business enterprise coverage. If he refuses you will in all possibility have a valid declare by way of the exertions family members board. you ought to have been immediately notified of your COBRA entitlement if coverage replaced into cancelled for any reason.

Answer 5

have to call the company and find out what the deal is. I expect your states insurance commissioner can help you out if necessary, but I bet it's just computer idiocy going on.