• Insurance Cancelled

    Asked by ibcarolek on Tuesday, April 2, 2013

    Insurance Cancelled

    John just found out his employer stopped his insurance in January, but everyone just got clued in today. His boss didn't even know his coverage had been yanked. John hasn't gotten any Cobra information. His insurance covered Kaiser, an HMO out here in CA. When he went to ask Kaiser how much insurance would be if he paid out of pocket, they said they may not carry him and he'd have to go through a review process. I thought it's not allowed to refuse coverage for preexisting conditions, but they said that is only for children. Ah to be young again!

    We're following up to see what we can do to get Cobra going, but I'm not sure what to do for the gap inbetween getting it started and now. He's got his chemo appointment tomorrow - I'm not sure if they'll cover him or do it. Any advice or guidance or something to stop our panic?

    10 Answers from the Community

    10 answers
    • Clyde's Avatar
      Clyde

      I think you should contact a lawyer in CA about this to be absolutely sure. You could also check on line to see if anyone else has gone through a similar situation. Something simple in google like. "Insurance canceled by boss in CA." or "Kaiser cancels insurance, will not continue with patient." should bring up several answers.

      over 4 years ago
    • SueRae1's Avatar
      SueRae1

      I don't know about CA but in NY state it's illegal to refuse coverage or charge more to someone who has a preexisting condition, if they have been insured within the last year.

      Ask Kaiser why they did not send you a letter of termination. they are legal bound to do so when coverage is stopped. They are as culpable in this mess as your DH's employer. See a lawyer about writing a letter to the insurance company and what actions can be taken against both the employer and Kaiser. Sometimes a letter on a law firms stationary can work wonders.

      Also speak with the cancer center your husband is being treated at and explain the situation, a social worker or other oncology center personnel can help you navigate your options work with you to make sure that your insurance is restored.

      I know the oncology billing department of Columbia Presbyterian Hospital were extremely helpful in helping me resolve issues with my COBRA coverage, my former employer gave me the wrong address, amount and forms to send in, I suspect had it not been for the billing department I never would have resolved my issues.

      over 4 years ago
    • SueRae1's Avatar
      SueRae1

      here's a link to a website with a number to call with insurance questions and issues, they may be able to help you.

      http://www.dmhc.ca.gov/dmhc_consumer/pc/pc_default.aspx

      over 4 years ago
    • carm's Avatar
      carm

      ibcarolek,
      You might want to contact the Patient Advocate website at patientadvocate.org. Also you can get help on NeedyMeds.org if you go to the tab markied Diagnosis-Based Assistance there is a list of National organizations and below a list by state. Best of luck to you, Carm RN>

      over 4 years ago
    • INSBOB's Avatar
      INSBOB

      if john was covered by a large firm (many employee's) he should first contact the california state insurance department and they will probably tell him to contact the federal government regarding Erisa. cobra laws mandate that the employee gets notified regarding termination of insurance and the right to continue the insurance (jim must pay for it) for 18 to 36 months depending on the reason of termination. unless he did something illegal to get fired. don't start spending money on a lawyer till later if needed. also pre x doesnt come about in many states (not jersey if you had prior coverage) till jan 1, 2013. many prayers and good luck. insbob.com

      over 4 years ago
    • NanaL's Avatar
      NanaL

      I stopped working on Feb 5th and went out on short term disability thru my pension plan. I also applied for SSD in Jan and was awarded benefits in March but payments won't begin until August. I have been doing cobra thru my work and received paperwork from payroll and HR giving me choices of my elections and when the first payment was due etc. I also received a letter of termination via email. I worked for a large employer. Best of luck to you and let me know if i can help answer any other questions. Something definitely isn't right about all of this!!

      over 4 years ago
    • Lirasgirl33's Avatar
      Lirasgirl33

      I agree, everyone including John should have received a letter of termination. You need to call and speak to the employer and insurance company to find out what happened and what needs to be done to fix this. What they did is wrong.

      over 4 years ago
    • ibcarolek's Avatar
      ibcarolek

      Thank you everyone! The company says they'll reinstate John's insurance, saying it was a clerical error. John ironically got the letter today notifying him of his 'employment being terminated' on 12/31, along with providing cobra paperwork....Anyhow, we're hopeful the reinstated insurance will pick up the last three months of chemo - the hospital is continuing chemo with our signed promise to pay. We're hopeful they really mean getting insurance back. John's boss has been great in cutting through the company's paperwork, realizing we were too freaked out to deal. We've never known how long his company would continue to carry him - and thankfully it looks like a bit longer. We'll see where we land when state disability runs out in a couple of months. One adventure at a time!

      Thank you again for your support and sage words of advice and suggestions. It gave us action and helped focus the panic.

      over 4 years ago
    • Dennis76's Avatar
      Dennis76

      My mothers insurance was canceled mid treatment, she stopped getting kemo because she had no insurance or money, she stopped going to her doctors even because she had no way to pay. She paid her insurance all her life but after 180 days of not working they canceled her. Now were trying to get her on medicaid, but she has to cash in her life insurance and 401k first and spend it on things they seem fit to spend all her retirement on. She doesnt have long left, she is in hospice care now at home, im there all day with her. I just wish she didnt have to worry about all this while shes going through such a difficult time.

      over 4 years ago
    • Dennis76's Avatar
      Dennis76

      My mothers insurance was canceled mid treatment, she stopped getting kemo because she had no insurance or money, she stopped going to her doctors even because she had no way to pay. She paid her insurance all her life but after 180 days of not working they canceled her. Now were trying to get her on medicaid, but she has to cash in her life insurance and 401k first and spend it on things they seem fit to spend all her retirement on. She doesnt have long left, she is in hospice care now at home, im there all day with her. I just wish she didnt have to worry about all this while shes going through such a difficult time.

      over 4 years ago

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