Heath Insurance coverage Retroactively Cancelled?

By | November 6, 2018

On Saturday I obtained 2 letters from my medical insurance firm. The primary was an EOB denying labwork carried out on 09/26/18 as a consequence of “Member not eligible on date of service”. The second letter was was an official notification that my well being protection has been cancelled efficient 09/01/2018. This got here as an entire shock. Some backstory- Mid-August I left my job at a small firm who supplied medical insurance by Optima. After quitting I arrange an account for protection by COBRA. My medical insurance for August had already been utterly paid for. On 9/1/18 my COBRA account was paid for the month of September. A couple of days after that, I tried to fill a prescription and was advised I had no insurance coverage. I contacted Optima, who claimed they’d not obtained any data concerning COBRA protection. I referred to as the COBRA firm, who supplied a number of documented submissions to Optima concerning establishing my account. Over the following week, my COBRA firm continued to return and for with Optima, every time Optima claiming they did not obtain something. Lastly, the COBRA firm refused to get off of the cellphone whereas the data was submitted and waited for Optima to obtain it, and Shock! Optima obtained it simply wonderful when COBRA was on the cellphone. Since then, every little thing has been nice. I’ve had a number of drs appts, prescription refills, and so forth accomplished with no points. I used to be issued a brand new insurance coverage card from Optima with a begin date of 9/1/18. I’ve obtained each EOB up till now utterly authorized (together with a part of the go to on 9/26/18 which is now being denied). I’ve continued to pay for COBRA each month with no issues. Since I obtained cancellation letter on Saturday, I could not name till at this time. Optima initially claimed that I by no means had insurance coverage after 8/31/18. After explaining that I obtained a brand new card, had a number of EOBs in hand with protection paid for, they all of the sudden modified their story. Now they’re saying that COBRA notified them on Oct 18th to retroactively cancel my insurance coverage. So I contact COBRA. They had been taken utterly abruptly and haven’t any document of contacting Optima concerning cancelling my service. They promise to analyze. I name Optima again and clarify that COBRA didn’t cancel my insurance coverage. The consultant I spoke to this time was utterly nasty to me. She claimed that Optima does not “have something to do with COBRA” and that my “earlier employer referred to as them and advised them they did not wish to supply COBRA”. This made no sense in any way. Once I pressed on the truth that 1. I had insurance coverage protection up till (apparently) the 18th and a pair of. Optima had paid for issues between 9/1-10/18 with no drawback, the consultant really advised me that “Optima pays for issues in good religion then verifies you might be eligible for insurance coverage after the very fact. Now Optima goes to return after you for the entire cash they spent on you if you did not even have protection”. This was so past ridiculous that I simply gave up on the dialog. (When was the final time you heard of an insurance coverage firm altruistically paying for issues?!?! I adopted up with my COBRA firm, simply to confirm that my firm hadn’t stopped providing COBRA. Not solely did they verify that they had been nonetheless providing COBRA, however they identified that even when they did, it could not work retroactively. They’ve promised to succeed in out to Optima, however I do know from the previous that Optima can be extremely tough. What can I do on this state of affairs? How can Optima retroactively cancel my insurance coverage? Additionally, in the event that they had been notified 10/18, why did it take till 11/three to ship a letter notifying me? I nonetheless do not need any thought who supposedly notified them to cancel the coverage. Should not they legally have to supply that data? It appears actually loopy that they will simply declare that “any person” cancelled the insurance coverage and never have to supply any data on who that somebody was or whether or not they had the authority to really cancel the insurance coverage. Every little thing about Optima has been actually sketchy and each time I attain out to them they declare they cannot converse to me. (Once I was initially enrolling they claimed they may solely converse to by COBRA firm, now the most recent consultant claimed that since I am not enrolled, they cannot discuss to me in any respect). Please- any recommendation could be enormously appreciated! submitted by /u/Ryyn [link] [comments]