My dad has been working part time for a company that in addition to his token salary, they pay for both his and my mom's supplemental health insurance. We just found out (through a claim denial) that my mom was dropped from her plan in October. As far as we know she never received notification (but it might very well have been tossed by mistake) and my dad's company never disclosed this. I'll be going to their home tomorrow to try and straighten this mess out. Question is...does anyone know if the insurance co. (American Republic) is obligated in any way to re-instate her? I know the closing date was 12/7....is there anything I can do to gain coverage elsewhere if she is denied? My dad also fears he will be dropped on the first of January and will be scrambling as well to find coverage. They are 89 and 90 and mom has numerous health issues. Dad is holding his own for the time being, but to be without supplemental insurance this could be disastrous.
Thanks for the responses......after having to send in my POA to the insurance co. I contacted dad's place of employment. Unfortunately the ball was dropped and the payment due was ignored for that particular quarter by his employer, but was paid once it came to their attention. The insurance co. still insists mom was past the 60 day reinstatement period and would have to reapply and sent to underwriters, and could be denied coverage for pre-existing conditions (what 89 year old doesn't?) while being penalized by much higher premiums. This is still an ongoing conversation.
In the interim, while doing my own research, I found out that if the open enrollment cut off is missed or your Medical supplemental insurance has lasped .....this is indeed the protocol. EXCEPT in the states of Ct.,N.Y.,Ma. and Maine (Me. having some restrictions). The above mentioned states are Guaranteed Issue states, as long as the policy hasn't lapsed for more than six months. So....good news since we live in Ct. (at least there is some benefit living here). Worse case scenario we can get a new plan for mom without the scrutiny of underwriters for the open enrollment premium cost. But, if American Republic (out of Iowa) refuses to reinstate mom I will make a formal complaint to the insurance commissioner. Of course none of this is disclosed which makes this whole Medicare/Medigap circus even more confusing. As always ...... you are your own best advocate.
Wworried, I think what Abby meant was that it would be a shame to pay extra for hospitalization and medications that are supposed to be covered by insurance.
Her parents ARE using their own money to pay for their care/housing. Ultimately, they need placement (which they are fighting) but which will be private pay. THAT'S what the funds are needed for.
As said, an employer is not responsible to pay premiums for p/t employees.
How is ur parents income? Maybe they will qualify for Medicaid healthcare.
I would also verify where they are sending notices, this could be going to an HR person that just circular files it because they don't recognize the name. Make sure that your parents address is in their system.
It is difficult to get other insurance when you have been cancelled for nonpayment, you really want to get this taken care of, even if they have to pay.
Is it still within 30/60/90 days? Can you throw yourself on the company's mercey? Contact their president or CEO if necessary.
I would not assume mom has been dropped. It may be that the claim has not yet gone through the Medicare part B claim process.
Call the supplemental plan tomorrow and dont say "dropped". Simply inquire why the claim was denied and how the claim can be resubmitted.
If indeed the policy has been dropped, please use this as an opportunity to browbeat your father into submission about getting him and mom into care so that mistakes like this don't happen
And you are so right....this is a clear indicator to move on.