tldr: Will the amount spent under one insurance plan carry over to another of the same provider?
I work at a small company of under 20 employees. At the beginning of the year, there were talks about changing our insurance to an underwritten plan with cheaper premiums. This fell through because less than half of us would be on the plan, but then a couple people quit in the next few months and on 4/28 it was announced that we would be changing to that plan effective 5/1. I thought this would just be a decrease in premiums, but it turns out it’s an entirely new plan with a different group/policy number.
The problem, though, is that my wife has MS and gets a monthly infusion which is basically guaranteed to hit the out-of-pocket maximum after one or two months. She has also already gotten her May infusion before I found out it’s a new policy (but it explains why the infusion center was having problems pulling up our insurance…we still went through with the infusion because they tried pulling the insurance in the middle of it. Cool. Thanks.). We called UHC and they said the old policy had termed, so I don’t think we could keep her on the old plan if we tried.
Both plans are with UHC, so will the amount we’ve spent so far this year carry over to the new plan? If not, we’ll be on the hook for about $12,000, so we’re both super stressing about this. Is there anything we can do if it doesn’t?
We’re both extremely frustrated at my work, besides the money aspect, since this is the second time they have played with her livelihood this year. For years I have tried to get my work to start their policy year in January like what almost everyone else has, but it’s never worked and has always been February. Since she had previous coverage ending 12/31/21, she had to risk a flair-up and stretch her infusions from late December to early February, skipping January entirely (Now with this change the policy year starts in May, so if for some reason we switch her to a different plan next year it’s basically impossible to switch back to this one). My wife mentioned seeing if there’s some legal action we can take since we had less than 3 days of warning, but I don’t know if there’s anything there since they did give some warning.
submitted by /u/spybloom
[link] [comments]tldr: Will the amount spent under one insurance plan carry over to another of the same provider? I work at a small company of under 20 employees. At the beginning of the year, there were talks about changing our insurance to an underwritten plan with cheaper premiums. This fell through because less than half of us would be on the plan, but then a couple people quit in the next few months and on 4/28 it was announced that we would be changing to that plan effective 5/1. I thought this would just be a decrease in premiums, but it turns out it’s an entirely new plan with a different group/policy number. The problem, though, is that my wife has MS and gets a monthly infusion which is basically guaranteed to hit the out-of-pocket maximum after one or two months. She has also already gotten her May infusion before I found out it’s a new policy (but it explains why the infusion center was having problems pulling up our insurance…we still went through with the infusion because they tried pulling the insurance in the middle of it. Cool. Thanks.). We called UHC and they said the old policy had termed, so I don’t think we could keep her on the old plan if we tried. Both plans are with UHC, so will the amount we’ve spent so far this year carry over to the new plan? If not, we’ll be on the hook for about $12,000, so we’re both super stressing about this. Is there anything we can do if it doesn’t? We’re both extremely frustrated at my work, besides the money aspect, since this is the second time they have played with her livelihood this year. For years I have tried to get my work to start their policy year in January like what almost everyone else has, but it’s never worked and has always been February. Since she had previous coverage ending 12/31/21, she had to risk a flair-up and stretch her infusions from late December to early February, skipping January entirely (Now with this change the policy year starts in May, so if for some reason we switch her to a different plan next year it’s basically impossible to switch back to this one). My wife mentioned seeing if there’s some legal action we can take since we had less than 3 days of warning, but I don’t know if there’s anything there since they did give some warning. submitted by /u/spybloom [link] [comments]Read Morer/HealthInsurance