A new twist in my insurance crisis ...

[JNJarrett]

Okay, so I got a call from my agency and my doctors office today. Apparently the insurance issue is a little bigger than we thought. They back dated my cancellation to January 1st of 2008, (when I started COBRA coverage) so all of my medical bills are about to bounce back, including a stay in L&D for preterm labor back in April. The amount totals $6,500!

The insurance company or the coordinating company won't really give me a reason as to why this happened, except that DirecTV was in control of when this decision. To find out more I have to submit it in writing to cooperate headquarters and it will be 30 days before I get a response. They did tell me they will be refunding my COBRA payments.

The owner of the agency wants to wait until after I have submitted my dispute to pay for anything. She is thinking that it is an error on the date, even though the insurance company and the coordinating company have the same information.

I don't think my doctors office would be willing to wait that long. So I can look forward to every visit getting yelled at by the office manager. So I will most likely have to find a new OB at 33+ weeks. (good luck there ... huh)

Is it illegal what they are doing? Or can they just do whatever the heck they want? And I thought I was stressed before ...

[montanamom]

I don't know about illegal, but have you tried getting a policy from BCBS of Montana? There is no waiting for pregnancy coverage, and no surrogacy exclusion. My premiums are only $150 a month, and the deductible is $2500 with no copays or separate maternity deductible. Sorry you are having so many problems with insurance. What a pain in the @ss.

[JNJarrett]

Originally Posted by montanamom

I don't know about illegal, but have you tried getting a policy from BCBS of Montana? There is no waiting for pregnancy coverage, and no surrogacy exclusion. My premiums are only $150 a month, and the deductible is $2500 with no copays or separate maternity deductible. Sorry you are having so many problems with insurance. What a pain in the @ss.

BCBS denied me! But I got on my husbands policy effective as of July 15th, (as soon as we learned I was dropped, but we thought it was only since June that I was not covered) there is no waiting period or anything since he already had the plan in effect and it does not cost us any extra. I am covered from here on out, just trying to figure out about the last 6 1/2 months that my coverage was just cancelled for

[montanamom]

Unfortunately, I have heard horror stories about insurance companies being able to do what they want to. If it isn't a crime, it should be. I hope that it is just an error, and they will cover it. And, even though I know this will be hard, try not to stress too much!

[momof4andmore]

wow, I am sorry you are going through all of this!

[NrthCenTXIPs]

Hey Nikki,

I am so sorry you are having such problems with the insurance. COBRA plans are always looking for a way to drop you. But I dont think they can back date if you had paid premiums for the past months.

I am a paralegal and I could ask my boss, but he is out of town until Tuesday next week, if you can wait that long. But I also have other attorney friends that I can check with in the meantime. I can also look up the federal regulations for COBRA. I am not sure though if it is State specific. Let me see what I can find tomorrow and I will let you know.

[Meadow]

From working insurance claims for a local hospital before having my toddler they can take back all the money they paid within a certain time frame. That time frame is based off the contract they have with that doctor and or hospital and they usually make it the same for every place they deal with. Alot of times its 5 yrs. If they feel there is a error they can take back the money.

Now as far as canceling your cobra... that part i dont know about and its the first time i've heard of that. I have heard of them deciding they paid the pregnancy in error but never heard that they covered someone in error and paid back premiums paid unto them!