Pregnancy billing when switching insurance - how is a gap handled?

Question

My wife is pregnant.

My last company was a startup that went under, and although we had a group plan - the company group plan is no longer around. The company was also a small company with less than 10 employees - so I assume that COBRA does not apply to my past company.

She is due in October.

From June 1st to July 31st, we don't have coverage.

The OBGYN bills for the whole pregnancy at the end. Do they just bill my previous insurer for stuff up to May 31st, bill us for the June 1st to July 31st (which would be basically office visits and checkups) - and then bill the new insurer for everything at the end?

Transition insurance wont cover pregnancy, so that's not really an option either.

Answer 1

COBRA will not be offered, not only because of less than 10 employees but also because the group policy is no longer valid.

The new insurance company will only officially pay for the visits after the effective date. However, the doctors office will probably bill the entire amount to the new company, which will probably (but not always) deny coverage prior to the effective date. The doctors office will then bill the previous company as well as you. So you might luck out and the new insurance company will cover it all.

Answer 2

I don't have an answer to that question but did COBRA say you couldn't be covered?  If not, their toll free #1-877-279-7959

Answer 3

Happens all the time. The doctor will prorate the global package. Meaning, you'll be billed for the 2 months you have no coverage. The old plan will be responsible for the services rendered while with them. The new plan will cover everything after she becomes effective.