If your medical insurance is active at the time that services are rendered...?

Question

do you still have to be covered in order to have the claim paid? In other words, if coverage ends before time allows the claim to be paid, will it still get paid, or will the bill have to be paid out of pocket?

Answer 1

What matters is the time of service. Let's say you're seen on the 30th of March, and your plan ends on March 31st. The claim should be paid because benefits are determined based on eligibilty at the time of service.

Answer 2

if the insurance is active at the time of care they still have to pay.. even if the billing is sent months later.. they still have to pay when it was active.. so no you do not have to pay.........

Answer 3

OK, if your medical policy is active, that means, you're covered, at the time service is rendered.   They have to pay.  If your policy cancels before the check is written, they're still on the hook.

Answer 4

I had this come up before with my personal insurance.  If the insurance is in force the claim should be paid by the company.  If the claim happens even one day after the policy lapses then the company is not liable.

Answer 5

It should be paid if it was in force at the time services were rendered.  Most insurers, however, have time limits for submittal of claims.