Are there any programs to help you with back bills if your Health insurance cancels you?

Question

Why aren't they required to refund the money you paid for it if they didn't provide you the service?

Is there anything that can help with back medical bills?

I wasn't cancelled because of anything serious, just something I didn't realize I was diagnosed with-PCOS-wasn't on my app. It wouldn't have prevented me from getting the coverage. So what can I do?

Answer 1

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Answer 2

The only way you'd get your premium back would be if they had never paid out any medical claims for you.  Otherwise, they deduct the value of what you paid in from the claims that they take back.  (So, technically, you are "getting back what you paid in," because it was taken away from the bills you're going to have to pay to your medical providers.)

And no...there aren't any programs that I'm aware of to help with past medical bills under that circumstance.  You're just going to have to work out payment plans with your providers.

This is why its important to disclose absolutely everything on an insurance application.  PCOS definitely would have been relevant to your insurer...either they wouldn't have issued you a policy to begin with, or you would have had a higher premium due to your medical status.

I don't say this to be offensive, but technically not disclosing something like that on your application is insurance fraud (whether you intended to deceive the insurer or not).  That's why you'll have a tough time finding a program to help you with the back bills.  Sorry.  :(  (And I hate to be the bearer of bad news, but this might also make it a little harder for you to get coverage right now...unless you get group coverage through an employer, of course.)

Answer 3

Each state is different, and there is a difference between canceling and rescinding a police. If the policy was rescinded you may get your premiums back, but they are not going to pay any previous medical bills. If the policy was canceled, which I doubt, they should  pay for covered services while the policy was in effect.

Insurance companies are gun shy right now about rescinding individual policies due to a recent court case in California. Call the insurance company and see if there is an appeal process. If you are not satisfied with their response, contact your states insurance commissioner's office for more advise.  

Don

http://mtnhealthinsurance.com

PS: I think PCOS is cause for denial, but I am not an underwriter.

Answer 4

Dr. M.

I would recommend checking the website of the state department of insurance in your state, for non-profit's in your area that may be able to help with some of the costs.  

When you are canceled retroactively as in your case, what happens is that they look at the dollar amount of any claims that they had already paid on  your policy and they subtract that amount from the premiums that you've submitted up until that point.

If what they've paid in claims is equal to, or greater than what you paid in premium, you will NOT receive any premiums refunded to you.  

I hope that information has proved helpful.  Good luck!

Kathy K

www.premiumwatchdog.com