Will I be responsible for charges while switching insurances during pregnancy?

Question

I'm 6.5 months pregnant. I was on my guardian's insurance but she JUST recently got a letter stating they were removing me off her insurance as of my 19th birthday (3/31) because I was only a part time student. As soon as I found this out (last week) I went to the Department of Social Services and applied for insurance through the state. I'm eligible, but I'm still waiting for my confirmation to come in the mail. They never told me how long it was going to take for my application to go through.

I technically haven't had insurance since 3/31 but I didn't know it, I've gone to 2 maybe 3 doctor appointments, and I have one coming up next Tuesday.

Will the state pay for the appointments that I went to with no insurance when it kicks in? Or will I be responsible for those charges?

Answer 1

most state programs cover the whole pregnancy.  The doctor usually does not bill until delivery and then you would have the hospital charges for the delivery.  It depends on each states policy some states will make the coverage retroactive.  If that should happen you would not owe any balance if not then unfortunately you will owe the balance.  You should not have many bills other than lab and ultrasound.  If you have balances at a hospital call their business office and ask of they offer any programs that offer assistance.  The facility I work for has what they call charity care and if you qualify we adjust your balance to 0.

Answer 2

They could go back to the date of your application, assuming you get approved, and pay for any visits from the application date forward.

Answer 3

When you applied, did you ask for retroactive coverage? If not, you can do that once you are approved. You may need to supply additional back-up documents, but there will be no break in coverage. Make sure your doctor accepts medicaid though!

Answer 4

You will be responsible for charges while you are not covered by insurance.  I would question why you weren't notified before the date of termination though.  The state plan will not cover any visits prior to your effective date, so you will need to find out what that is.  There are laws in place to protect you in the case of unpaid medical bills, so you should look into that.

Answer 5

Medicaid will cover retroactively up to three months. However, it can take two weeks to three months to get approved. There is no way to know if the doctor visits will be covered until you've gotten your approval from Medicaid and filed a claim with them.

FYI - not all doctors accept Medicaid, and if your doctor doesn't you may be required to pay at least the difference if not the total charges. Also, you may have to get another doctor while on Medicaid.