they cancelled my health insurance (I just had surgery)

Nurses General Nursing

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Specializes in Med/Surg, Home Health.

I had been planning on having surgery for about 4 months and had discussed it with my manager so she was aware. I waited 4 months because we were short-staffed and it would make it hard on everyone with my being off work. When I finally decided I needed to do it, my manager asked me to wait another month, so I did. Well, Oct 15 I had my surgery, Ive now been off work for 5 weeks and got a notification in the mail 3 days ago that my insurance had been cancelled 2 months ago! I was never notified. I called the insurance company, they said that my workplace sent them a letter on Nov 6 to cancel it effective September. Now I have this huge surgery bill, I cant afford my meds, etc. We just had our open enrollment 2 weeks ago, I did my paperwork with no problems, nothing said or mentioned about any cancellation. So to my knowledge, I still had insurance. I pulled out my old paystubs, they had stopped taking out my premiums a couple months ago! What can I do? I mean, its their fault, not mine. At the time the premiums stopped coming out of my check was the same time I got a raise, so I didnt notice any change in pay, no need to investigate every paystub. Our paystubs are so confusing, no one looks at them because they make no sense. I trusted them, took for granted everything was ok, Ive had insurance for 2.5 years with them with no problems. Anything I can do about this? Its almost like they are wanting to get rid of me.

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I think you should have gotten a warning that you were going to lose your coverage. Try contacting the insurance commissioner to see if you have anything to stand on.

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Specializes in ob/gyn med /surg.

why did they suddenly cancel your insurance? it seems so strange, i would call human resource and find out what it going on. what a crummy thing to do... i don't understand it at all. call the insurance company and ask them. please keep me posted.

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Specializes in Corrections, Cardiac, Hospice.

How can they cancel your insurance after the fact? Something sounds fishy to me. I think you need to dig deeper.

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Specializes in Med/Surg, Home Health.

Well, I did call the insurance company today and they said that they received a letter on Nov 6 from my employment to cancel it...effective in September. I dont understand how they can backdate it either. I went to HR today and conveniently there was no one there who could help me, was told to come back, took my name and number. The insurance company just told me to contact my employer. I dont know. Im going tomorrow to see what I can find out, but I have a feeling that I'll get the run-around again. I didnt receive anything prior to the cancellation. I went the other day to get my prescriptions filled and was told by the drugstore that my insurance was "expired" and had to pay full price. THATS how I originally found out. But I thought it was just a mistake at the drugstore at that time. Hmmm, was I wrong! I'll post again after I talk to HR, but I just have a bad feeling that tomorrow I may be unemployed unless they make this right. I cant afford to pay for my expensive surgery, not after paying for health insurance for all this time, and with them KNOWING I was having surgery on this date. I feel so betrayed.

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Specializes in ER OB NICU.

Number One. I think that you should contact other employees to see IF ANY of them received any type notice about insurance being cancelled, or changed, or whatever and new paperwork required. As , if they did, and you did not turn yours in, then that may have happened. Two. Open enrollment is usually held in October every year, and if people don't make changes then, then they have to wait another year to do so. 3. IF you were cancelled, then the company , at least in my state, by law have to contact you and offer you Cobra coverage for the next 18 months, as you have been continuously covered for a year. The problem being that since they did NOT contact your company until Nov.6, the company probably had no reason to contact you as they thought your were covered, and in additon, probably gave the OK for your surgery, and have probably already paid for it. When you were preadmitted, IF YOU HAD NO INSURANCE coverage, then they would have told you at the time, as they precertify EVERY admission prior to admitting you for the surgery. Also, they evidently have been covering all your meds up till now. IN addition, if the manager knew you planned surgery, and asked that you wait, then maybe they are trying to pull something. I don't think they can cancel insurance two months after the fact. Perhaps when you went on medical leave, you did not have enough time to pay for your time off in vacation, sick pay, etc, and you should have filed for FMLA, to keep your job. UNLESS EVERY employee had their insurance terminated at the same time or changed, you cannot be singled out, UNLESS You don't pay your premiums. While on medical leave, (FMLA) you are required to pay for the health insurance IF you do not have enough timebuilt up to pay you to be off the entire time. BUT for the 12 weeks of FMLA, you only have to pay your portion to keep it. Have you received checks the whole time you have been off? When did you plan to return? did you give them your drs. excuse? There are many things that enter into this. I would go to HR. and ask them to explain, and if they can't get the person you can, and get it straightened out. Check any EOBS you have gotten from the ins. co saying they have paid for the surgery, meds, etc. The company contracts with all the providers, and EVEry provider checks with the company before handing over services at the insurance pro rated rate. Post more, and I wll try to help. We had to get the Dept of Labor to settle my husbands FMLA>

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If they cancel you don't they have to offer COBRA coverage? I had to stop my sones due to his age and a letter arrived not 3 weeks later offering it.

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Specializes in Corrections, Cardiac, Hospice.
Number One. I think that you should contact other employees to see IF ANY of them received any type notice about insurance being cancelled, or changed, or whatever and new paperwork required. As , if they did, and you did not turn yours in, then that may have happened. Two. Open enrollment is usually held in October every year, and if people don't make changes then, then they have to wait another year to do so. 3. IF you were cancelled, then the company , at least in my state, by law have to contact you and offer you Cobra coverage for the next 18 months, as you have been continuously covered for a year. The problem being that since they did NOT contact your company until Nov.6, the company probably had no reason to contact you as they thought your were covered, and in additon, probably gave the OK for your surgery, and have probably already paid for it. When you were preadmitted, IF YOU HAD NO INSURANCE coverage, then they would have told you at the time, as they precertify EVERY admission prior to admitting you for the surgery. Also, they evidently have been covering all your meds up till now. IN addition, if the manager knew you planned surgery, and asked that you wait, then maybe they are trying to pull something. I don't think they can cancel insurance two months after the fact. Perhaps when you went on medical leave, you did not have enough time to pay for your time off in vacation, sick pay, etc, and you should have filed for FMLA, to keep your job. UNLESS EVERY employee had their insurance terminated at the same time or changed, you cannot be singled out, UNLESS You don't pay your premiums. While on medical leave, (FMLA) you are required to pay for the health insurance IF you do not have enough timebuilt up to pay you to be off the entire time. BUT for the 12 weeks of FMLA, you only have to pay your portion to keep it. Have you received checks the whole time you have been off? When did you plan to return? did you give them your drs. excuse? There are many things that enter into this. I would go to HR. and ask them to explain, and if they can't get the person you can, and get it straightened out. Check any EOBS you have gotten from the ins. co saying they have paid for the surgery, meds, etc. The company contracts with all the providers, and EVEry provider checks with the company before handing over services at the insurance pro rated rate. Post more, and I wll try to help. We had to get the Dept of Labor to settle my husbands FMLA>

Looks like you got great advice from someone who knows what they are talking about. Good luck and keep us posted.

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Here's my 2 cents.

They screwed up, they need to fix it. But, don't be all nice and go for the "talking with HR" route right from the get-go. In my experience, being nice generally doesn't get you far, or at least significantly prolongs the timeframe of actually getting things fixed.

Draft a letter to HR with exactly what you stated above. Emphasize that you NEVER gave any notification to HR to discontinue your health benefits, and that in retroactively discontinuing your benefits WITH NO CONSENT OR NOTICE is illegal. Give them a time frame (like say, 2 weeks - give a definite drop dead date) to 1) contact the insurance company 2) work with the insurance company to ensure they reprocess every single last stinking claim ASAP, 3) Immediately contact patient financial services or at least provide a letter that you can provide to hospital, docs, labs, etc. to inform them of the error made in insurance and that YOU are NOT responsible for the balance and that they are NOT to bill you or take any further collections actions against you. If by due date this is not done, state that you have prepared a complaint form for the Commissioner of Insurance in your state and will have no further option except to fax this immediately to both them and your attorney for further legal action.

Make sure you do a cc: legalfile on the bottom of your letter, then sign and mail it off to HR registered mail/return receipt requested. I'm willing to bet you will get this resolved quickly with little to no further hassle on your part.

Complaints are like charting....if it's not written down, it never happened.

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Specializes in Med/surg,Tele,PACU,ER,ICU,LTAC,HH,Neuro.

I have one thing to say ....woe.

Dagger in my heart.

Imustbecrazy,

is not crazy she is right.

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Specializes in ICU, SDU, OR, RR, Ortho, Hospice RN.

Hmmm I did not realize they could just stop your insurance without some for of notificiation.

I would follow this through to the end.

Who made the decision to ceace the insurance is what I want to know.

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