I live in Illinois. I worked at a job that offered Blue Cross Blue Shield of Texas. In December 2019, they laid off my entire department. My benefits dept told me I’d have my PPO insurance through 12/31/19. Fully prepared to have my coverage cut off, I continued to go to my chiropractor and functional medicine appts (same medical provider) and discovered that despite me not paying premiums, my insurance policy was still active. Being unemployed with many medical issues in a pandemic, I didn’t contact BCBSTX or my former employer, instead passively waiting for the policy to lapse. I continued to receive Coordination of Benefits questionnaires and claim finalizations as if I still had coverage.
Fast forward to February 2021: I received my usual statement from my medical provider, with a substantial increase in money owed. When I called them, they said that insurance was no longer covering claims as of 1/1/21. Fine, party’s over, I thought. On the statement, claims from 2020 were still covered and paid for by BCBSTX.
Fast forward to July 2021: My medical provider called me stating that BCBSTX had rescinded all the payments they’d made for claims from 2/1/20 to 12/31/20, leaving me on the hook for more than $3,000. This rescission came over six months after the last claim, and therefore after I could appeal any claim takebacks. I knew there was no way BCBSTX could have been covering me out of the goodness of their hearts, but I was not expecting a cluster like this. Upon contacting BCBSTX, they said the backdate order came from my former company on 12/23/20. How there could be such a time lag, especially when my statement from Feb 2021 still showed my 2020 claims as paid, is beyond me. I repeatedly tried to get proof of payment for 2020 premiums from BCBSTX, to no avail.
Do I have any legal recourse? I’ve never gotten a lawyer before and am clueless as to where to look. I’m also still unemployed, so money is a consideration. Any help would be appreciated.
submitted by /u/grandtheftzeppelin
[link] [comments]
I live in Illinois. I worked at a job that offered Blue Cross Blue Shield of Texas. In December 2019, they laid off my entire department. My benefits dept told me I’d have my PPO insurance through 12/31/19. Fully prepared to have my coverage cut off, I continued to go to my chiropractor and functional medicine appts (same medical provider) and discovered that despite me not paying premiums, my insurance policy was still active. Being unemployed with many medical issues in a pandemic, I didn’t contact BCBSTX or my former employer, instead passively waiting for the policy to lapse. I continued to receive Coordination of Benefits questionnaires and claim finalizations as if I still had coverage. Fast forward to February 2021: I received my usual statement from my medical provider, with a substantial increase in money owed. When I called them, they said that insurance was no longer covering claims as of 1/1/21. Fine, party’s over, I thought. On the statement, claims from 2020 were still covered and paid for by BCBSTX. Fast forward to July 2021: My medical provider called me stating that BCBSTX had rescinded all the payments they’d made for claims from 2/1/20 to 12/31/20, leaving me on the hook for more than $3,000. This rescission came over six months after the last claim, and therefore after I could appeal any claim takebacks. I knew there was no way BCBSTX could have been covering me out of the goodness of their hearts, but I was not expecting a cluster like this. Upon contacting BCBSTX, they said the backdate order came from my former company on 12/23/20. How there could be such a time lag, especially when my statement from Feb 2021 still showed my 2020 claims as paid, is beyond me. I repeatedly tried to get proof of payment for 2020 premiums from BCBSTX, to no avail. Do I have any legal recourse? I’ve never gotten a lawyer before and am clueless as to where to look. I’m also still unemployed, so money is a consideration. Any help would be appreciated.
submitted by /u/grandtheftzeppelin [link] [comments]Read Morer/HealthInsurance