LOVELY - I have been denied insurance coverage

[DeposeTheBoyKing]

My insurance from my job lapsed, and I didn't do the COBRA thing. (I didn't return to work after a 3-month absence for herniated discs, but would have been laid off anyway had I returned). We applied to have me added to my husband's insurance during the open enrollment month. However, I got a denial letter today. No reason given, but I suspect it was due to the back problem. I also have high cholesterol which is being treated, as well as hypothyroidism, also under treatment. I can appeal, but do I really have a chance of success? I thought about contacting my orthopaedic surgeon who treated my back problem to see if he can write a letter on my behalf Naturally it's Friday afternoon and the office is closed, it being 5:11 now.

I don't like being without insurance. I feel I have to drive very, very carefully to avoid accidents and just hope nothing happens to me. Does anyone have any experience with this?

[XemaSab]

1. Don't get sick!

:P

[DeposeTheBoyKing]

2. Thanks - that helps

Arrrgggghhh.

[XemaSab]

5. No, but really

I don't have insurance either.

And yeah it sucks. :P

[TZ]

3. When did your insurance lapse?

If you were covered less than 60 days ago and can provide proof of insurance, you might win your appeal (I'm thinking a pre-existing condition is the reason for rejection,)

[DeposeTheBoyKing]

4. My insurance lapsed May 30th

This is so depressing. Guess I might have to find a job after all.

[yellowdogintexas]

9. hey, you are still within your 60 days, do you have your proof of creditable coverage from

the other carrier? That will stop them dead in their tracks, and if it is open enrollment they can't do that in Texas I do not believe. You can still get your COBRA, yeah you have to pay for the two months of covg you didn't use but hey that is less than a hospital stay would cost if you became ill and needed the hospital. Dig up your COBRA stuff, dig up the Letter of CC and KICK THEIR ASS.

who is the carrier, anyway? Doesn't MR DBTBK work for a hospital or something? They can't do this anywhere the HIPPA laws prevent this. One of Big Dawg's greatest gifts to us was the Guarantee of Credit for prior coverage.

You have 90 days to get your COBRA from the expiration date of the coverage.
You have to go longer than 60 days w/o coverage to even be considered for pre ex if it is small group or individiual.
Your former insurance HAS to provide you with the Letter of Creditable Coverage within 30 days of your end of coverage. You should have received this information no later than June 30. This letter is your lifeline!!!!!

In open enrollment they can't refuse you, if it is just him trying to add you at an out of order time due to life event (which you losing your plan is) then they can try to deny you but not in open enrollment. Even if it is due to a life event, the Letter of CC over rules everything.

Go get em Tiger

[DeposeTheBoyKing]

10. I don't know what a "proof of creditable coverage" looks like

Should I email the HR guy at Legal Aid? I did get a COBRA letter, but stupidly pitched it because I thought I wouldn't have to use it. Stupid, stupid, STUPID.

I had BCBSTX at work, and this plan is UT Select, also through BCBSTX.

[yellowdogintexas]

12. It says Health Insurance and Portability Protection Act at the top

and explains that you were covered from ...x date to ..y date. I would most certainly let the HR person at Legal Aid know you don't think you got the HIPPA letter in a timely manner. Get him to get them to fax you another one or email as an attachment. Copies of the insurance card that you had will also help because the new carrier can verify the benefits. BCBS TX can provide you with it as well.

Your HIPPA may have been with the COBRA stuff...although the COBRA stuff usually comes from the employer or benefits administrator whereas the HIPPA letter comes from the carrier. Is it possible you received it and didn't open it or something because you thought it was another EOB?

[DeposeTheBoyKing]

14. I was opening everything from BCBSTX because I was having so many treatments done

I don't remember seeing anything like this.

Thanks for your help - do you think I should call BCBSTX Monday to tell them I never got that letter? I did email our benefits guy.

[yellowdogintexas]

15. yes do it. You need that letter. nt

[DeposeTheBoyKing]

11. I just looked at the COBRA info I received at orientation

It says I only have 60 days. I guess my insurance coverage expired on May 31st, so I still have a few days. I'm going to email the LANWT benefits coordinator and ask what to do. I'm also going to call BCBSTX and tell them I never received that letter. Mr. DTBK also emailed his insurance person at work and told him about it.

Grrrrrr!!!

[pitohui]

6. how they can refuse you if you're legally married?

i went w/out insurance for many years but once i was married my husband's insurer could NOT refuse me

what state is this?

surgeons are not insurance experts, i think you need to talk to a lawyer who specializes in insurance and/or employment issues

who would marry if they could be refused under their spouse's insurance coverage? this is the major reason why people get married in the first place, instead of living together

i don't think finding a job with health insurance will happen, if you have a chronic condition who is going to hire you and put you on their insurance, at least this was my situation, getting married was my only option to get health insurance at pretty much any price

[DeposeTheBoyKing]

7. Yes, we are legally married and have been for almost 13 years

We are in Texas (I hate it).

I had treatment for 2 herniated discs from February through April 2008. No surgery, but I had to have 6 weeks of physical therapy and 3 lumbar injections. I feel great now and am exercising almost every day, but I think they rejected me because of this. I guess I should have lied on the application.

I am a lawyer, BTW. I'm not practicing right now. I've never had any trouble getting on my husband's insurance before - he just had to add me when he started a new job. I went off of his insurance when I got my job last October, and now I see I shouldn't have done that.

On Monday I am going to call the company and inquire as to why I was denied, as no reason was stated. I'm not certain, but I believe I have a right to be told the reason I was denied. I still think I might go to my surgeon to see if he'll write a letter stating that I complied with all therapies and am working to prevent any future back problems. I don't have any disabilities and have no history of cancer, heart attack, stroke or other serious medical conditions.

This sucks big-time. I have a family history of colon and breast cancer and would like to be able to get my screening procedures done without having to pay hundreds upon hundreds of dollars. I have sympathy for people who don't have insurance. Of course, Mr. DTBK is looking for another job - I hope I'll be able to get on his insurance once we move elsewhere. This state sucks.

[eyesroll]

8. I thought an employer plan wasn't allowed to reject you during the open enrollment.

:shrug:

[quakerboy]

13. Havnt had insurance in

years, now. I avoid thinking about it, because if I do, I start getting a bit paranoid about illness and injury.

In the mean time, my advise is to avoid becoming a hypochondriac. At least until you have coverage again. Also, don't get cancer.

[Breeze54]

16. My son has a disability and he was denied also.

I feel your pain.