I had medical insurance through my work in 2021 and decided during open enrollment, to drop the health insurance through my work and sign up directly through the marketplace health insurance for 2022, as it was more affordable then that offered in my job.
The Dilemma
My wife had surgery in December 2021 for an eye graft precudure. A few days ago, I recieved a phone call from their billing dept that insurance was denied and wasn’t affective during the surgey.
After investigating on my end, confirmed that the medical insurance I had from my work isn’t active from Jan1-Dec31, but Dec 1 – Nov 30! My new insurance that I signed up for during open enrollment became effective Jan 1 2022. This left us with no active health insurance for the month of Dec in 2021, when my wife had the surgery.
This was a major misunderstanding on my end, as until now, I have always been under the understanding that health insurance is active for calendar years and had no idea that the insurance wasn’t effective during Dec. 2021.
I called both my current and prior health insurance providers explaining the situation and both will not help. I called the NY State of Health, which is where I signed up for my current health plan to request if they can back date the insurance by 1 month. When I placed this request, they sounded pretty confident it shouldn’t be an issue as they allow to back date up to 3 months in the past, but today I just got a notice saying it was denied!
We have denied your request for help with paying medical bills for
December 01, 2021 through December 31, 2021.
This is because the program you are eligible for cannot pay for any care
you received in the past.
I put in a request to appeal this decision due to the nature of why I didn’t have insurance being a misunderstanding on my end. Obviously, if we knew we didn’t have insurance active in Dec, we would have certainly rescheduled the surgery!
So now here we are and the total amount they are charging for the surgical procedure is around $4,800! Which is something that will be extremely difficult for us to owe.
I would appreciate if someone with me knowledge in Health Insurance then I, can help with any advice.
submitted by /u/Defiant-Beginning436
[link] [comments]I had medical insurance through my work in 2021 and decided during open enrollment, to drop the health insurance through my work and sign up directly through the marketplace health insurance for 2022, as it was more affordable then that offered in my job. The Dilemma My wife had surgery in December 2021 for an eye graft precudure. A few days ago, I recieved a phone call from their billing dept that insurance was denied and wasn’t affective during the surgey. After investigating on my end, confirmed that the medical insurance I had from my work isn’t active from Jan1-Dec31, but Dec 1 – Nov 30! My new insurance that I signed up for during open enrollment became effective Jan 1 2022. This left us with no active health insurance for the month of Dec in 2021, when my wife had the surgery. This was a major misunderstanding on my end, as until now, I have always been under the understanding that health insurance is active for calendar years and had no idea that the insurance wasn’t effective during Dec. 2021. I called both my current and prior health insurance providers explaining the situation and both will not help. I called the NY State of Health, which is where I signed up for my current health plan to request if they can back date the insurance by 1 month. When I placed this request, they sounded pretty confident it shouldn’t be an issue as they allow to back date up to 3 months in the past, but today I just got a notice saying it was denied! We have denied your request for help with paying medical bills for December 01, 2021 through December 31, 2021. This is because the program you are eligible for cannot pay for any care you received in the past. I put in a request to appeal this decision due to the nature of why I didn’t have insurance being a misunderstanding on my end. Obviously, if we knew we didn’t have insurance active in Dec, we would have certainly rescheduled the surgery! So now here we are and the total amount they are charging for the surgical procedure is around $4,800! Which is something that will be extremely difficult for us to owe. I would appreciate if someone with me knowledge in Health Insurance then I, can help with any advice. submitted by /u/Defiant-Beginning436 [link] [comments]Read Morer/HealthInsurance