Question:
Does anyone know how insurance works when canceled...
I am scheduled for PS Jan. 26th and my insurance bc/bs is being cancelled Jan. 1st. Will they still pay for my surgery since they already approved it? I'm so upset over this. Thanks for the help :o) — Sandy M. (posted on November 6, 2003)
November 6, 2003
i am by no means the expert but I have seen other post about this. no your
insurance will not pay for anything after january 1st even if it was
approved. is it possible to explain it to your PS and get a date before
then? Good luck
— Delores S.
November 6, 2003
THEY WILL DEFINITELY NOT PAY ANYTHING AFTER THIS DATE. HOWEVER, YOU ARE
ELIGIBLE FOR COBRA CONTINUATION UP TO 18 MONTHS AFTER THE DATE YOUR
INSURANCE ENDS. THIS IS USUALLY SIGNIFICANTLY HIGHER THAN THE PREMIUM YOU
ARE PROBABLY PAYING NOW, BUT MAY BE WORTH IT IN THE LONG RUN.
GOOD LUCK!
SABRINA
— ANDREWS65
November 6, 2003
I'm sorry to say that they will pay for services incurred (not approved)
before the cancellation date, so they will not pay for the surgery on the
26th. A previous poster suggested COBRA continuation. This applies only
if you had group coverage, not to private policies. It also won't help if
your employer plan has simply changed carriers--you can't COBRA under the
previous one if there's a new plan in place. You also can't COBRA if the
employer no longer offers any health plan at all. So, COBRA may not help
you here. I agree with the first poster--see if you can get the surgery
moved up into December.
— Vespa R.
November 6, 2003
I think the laws on this may vary state to state. I had my insurance
cancelled on Sept 12, and the insurance company was required to give me a
30-day grace period, meaning I could still get medical services performed
through October 12. I had 2 endoscopies done in the beginning of October
(which were about $1000 each) and they paid for both of them, no questions
asked. Call the insurance company directly and ask them what your grace
period is after cancellation. In my case (and this may be federally
mandated) besides having the 30-day grace period for medical services, I
also had a deadline of one full year in which the doctor can still submit
his claims for services, as long as they were incurred either before
cancellation, or during the 30 day grace period. Feel free to email with
questions. As the other posters suggested, Cobra may be a better option
for you, particularly considering that you may have follow-up issues in the
months after surgery and will want to continue to be insured just in case.
Cobra is expensive, however. I think ours was going to be like $700 or
$800 for the two of us. Also varies from plan to plan.
— Tiffany J.
November 6, 2003
Tell your PS it's now or never. I'm sure if they don't want to lose a
patient they will work you in. Otherwise find some other good ones and
call to see when they could. With 7 weeks left before the end of the year,
someone should be able to do it. I'm sure your approval letter has their
standard language about whatever is in place at the time of surgery is how
the claim will be paid, well there won't be any policy, therefore no
payment. Sorry for the mess, I hope something can work out.
— zoedogcbr
November 6, 2003
Tell your PS it's now or never. I'm sure if they don't want to lose a
patient they will work you in. Otherwise find some other good ones and
call to see when they could. With 7 weeks left before the end of the year,
someone should be able to do it. I'm sure your approval letter has their
standard language about whatever is in place at the time of surgery is how
the claim will be paid, well there won't be any policy, therefore no
payment. Sorry for the mess, I hope something can work out.
— zoedogcbr
November 6, 2003
Why is it being cancelled? Are you going to a new carrier? Did you quit
your job? There are MANY things that go into cancelling insurance and what
happens next.
— Patty H.
November 7, 2003
Not omly will they not pay for it after Jan. 1, but you need to check with
your surgeon regarding follow-up care post-op 90 days out. My husbands
company is changing insurance Jan. 1st and when it came down to who the
surgeon accepted we had to change our minds as too who we wre going to go
with because they would take one type but not the other and I have to
change PCP inorder to be in the group they do accept. My date is Dec.4 so I
have been on the phone quite a bit the past couple days (all day) as a
matter of fact.
— Melinda W.
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