NY Marketplace – If I book a medically necessary surgery while uninsured, then enroll in insurance for the following year, can my insurance company refuse to pay for the surgery because I established a relationship with the surgeon prior to enrolling?

Hello,

I am currently uninsured and I saw a surgeon for a consultation about a medically necessary procedure. I paid for the consultation out of pocket and was given a surgery date in 2022. All of my pre-op appointments are scheduled for 2022.

I found out what marketplace plans this surgeon accepts, and I’m planning on enrolling with a plan they accept (Metroplus) when open enrollment opens. My surgeon encouraged me to do it this way.

Recently, someone told me that my insurance company may refuse to cover the surgery, because I already established a relationship with the surgeon and paid out of pocket.

Does anyone know if this is legal and/or likely to happen? Is there a way around it like going in for a second consultation?

Age: 26, Zip: 10003, Income: 45k

Thanks

submitted by /u/Tricky_Sir_8337
[link] [comments]Hello, I am currently uninsured and I saw a surgeon for a consultation about a medically necessary procedure. I paid for the consultation out of pocket and was given a surgery date in 2022. All of my pre-op appointments are scheduled for 2022. I found out what marketplace plans this surgeon accepts, and I’m planning on enrolling with a plan they accept (Metroplus) when open enrollment opens. My surgeon encouraged me to do it this way. Recently, someone told me that my insurance company may refuse to cover the surgery, because I already established a relationship with the surgeon and paid out of pocket. Does anyone know if this is legal and/or likely to happen? Is there a way around it like going in for a second consultation? Age: 26, Zip: 10003, Income: 45k Thanks submitted by /u/Tricky_Sir_8337 [link] [comments]Read Morer/HealthInsurance

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