Just lost insurance

mthomp2020

My husband was just laid off Friday.  He worked for an IT consulting firm.  According to what I've read in the emailed info, our insurance coverage expired at midnight on Friday.  It'll take a couple of weeks to get the Cobra paperwork and get it back to them.  I'm currently in treatment, being stage IV, and have an appt. tomorrow for chemo.  I'm planning on cancelling that in the morning, since it looks like we won't have any insurance until the Cobra paperwork gets done.  I'm eligible to go on Medicare part B, but that takes just as long.  I'm having them send me paperwork for that as well.  I stayed on his insurance because the coverage was better - probably a mistake on my part.  Though usually you can go on Cobra pretty much right away without any insurance gaps.

The weird thing is, the insurance premiums were always paid a month in advance, so you would think we'd have a couple of weeks of coverage, so I'm not sure how they're getting around this.  In the letter, it says that in lieau of notice, they're paying 6 weeks of salary. 

My husband was the one who spoke to the HR people.  They pretty much told him just to pay the bill and resubmit it for payment.  I'm going to need to call them on Monday and find out what all this is going to mean to me reagarding treatment.  We certainly can't afford to pay it out of pocket until Cobra kicks in - it would be over 5 figures just for Monday's visit. 

Just thought I'd throw this out there in case anyone had any suggestions or ideas.

Cynthia1962

Wow, Marsha, that's awful..as if you don't have enough to deal with.  I'm in CA, but maybe somethings are the same.  I've been told by friends who have been in the same situation, that they had a certain amount of time to choose Cobra and it was retroactive to the date they lost their insurance.  I would ask your onc's office, I am sure they will know.  You aren't the first person this has happened too, unfortunately.  I've never heard of one's insurance being cancelled so quickly and being paid instead.  Good luck and I'm sure you'll get more advice.

NJMarilyn

Marsha, my advice is to make sure there are no gaps in coverage so that you will be covered by the next insurance company.  There has to be continuous coverage.  In my experience COBRA is very expensive.  You might want to look into Medicare A, B and D with a supplemental plan.  That should be adequate for your needs.  Also, even if you are not over 65, you can get help from your county Office on Aging.  They are very knowledgeable on these issues.  Best of luck to you and your husband......Marilyn

mthomp2020

Cynthia, thanks for the input.  I'm hoping that's the case, that it's retroactive.  COBRA is a bit pricey, around $750 per month, but cheaper then paying for treatment!  I can switch to Medicare at any time, but it takes a few weeks as well.  The plus with the Cobra is that my husband is covered, otherwise we'll have to buy individual insurance for him, which is almost as bad.  Hopefully he'll find another job/assignment soon.  If he goes independent/self-employed again, we'll still have to get a policy for him anyway.

susan_02143

COBRA should be retroactive as stated above. For your protection, don't let your group insurance for more than 60 days. That seems to be the "reset" date.

I will state that COBRA isn't expensive, INSURANCE is expensive. When your employer has been footing the bill or a portion of the bill, you just aren't aware of the cost. The cost of COBRA should be what your employer has been paying for your plan, plus a small maintenance fee which many companies choose not to charge.

Hope that paperwork moves along quickly so you have peace of mind,

*susan* 

CoolBreeze

You must be very stressed.  I am not an expert in insurance but I did want to give you my sympathies.  I can't imagine a more frustrating situation.

mthomp2020

Thanks, Susan.  You're right about insurance.  Last time my hubby was self-employed, we had to buy insurance, and it was pretty expensive - I think about $500 at that time, which was about 8 years ago.  Plus the coverage wasn't as good as what we have now.  So I wasn't shocked by the cost.  It does take a load off my mind to know it's retroactive, which was what I thought, but still....!  Guess I'll keep my appointment tomorrow and let them know what's going on, and hopefully they won't ask me to fork over a bunch of money!  Think I'll pop an Ativan before bed tonight!

susan_02143

MT,

What should happen is, you get your appointment. At some point you will receive a bill which you will then send to the insurance company, or the best case, the bill will be sent to your insurance, be denied [if that is how the timing works] and then the doctor will just resubmit. It is best if you do not pay this bill out of pocket. It is really hard to get the doctor's office to fight for you if they have already been paid.

As a self-employed person in a much more expensive market, I would be thrilled with such a low health insurance premium!

*susan* 

chele

If you sign up for COBRA your coverage will be seamless. Your policy number will not change, your doctor's billing service won't even notice a delay.

peggy_j

Sorry you're going through this. Are you sure the insurance cut-off midmonth? That seems weird. 

I haven't applied for COBRA myself but I found this info from the Fed Gov't website. If I read this correctly, there's a short window to fill out the paperwork, but once you're signed up and paid, it seems to cover the period when you've lost your other coverage. (see Q13 below) There are also phone numbers you can call to get the straight info from COBRA (vs. relying on HR. Unfortunately, I've heard at least one tale of an HR person screwing up the COBRA paperwork process, so it can be good not to rely on them for all your info)

http://www.dol.gov/ebsa/faqs/faq-consumer-cobra.html 

Q13: When does COBRA coverage begin?
COBRA coverage begins on the date that health care coverage would otherwise have been lost by reason of a qualifying event. 

Like Susan said, I would be hesitant to pay any medical bill out of pocket and then ask to be reimbursed, just in case there's a screw up. Susan's strategy sounds right. You have more leverage and in some cases, docs/facilities write off fees they can't collect.

Good luck!  

CHH

Similar question. Our family insurance is through my husband's employer. He is going to be switching jobs within 3 months. I guess my question is...can I be denied coverage by a new insurer because of my pre-existing cancer? We also have the option of getting our family coverage through my employer-- and I wonder the same thing.

LuAnnH

Marsha,

I just thought about something, our onc have a group that works with all its patients.  No matter what the reason, if you have trouble paying your bill they will try to get the money to pay the bill for you.  You just have to call and talk to them and they can work with you to get all charges waived.  If you need the number, let me know I can get it for you or you can ask the onc's nurse for the number.  I have a friend that worked with them and they were able to help out.  Anything is worth a shot when it comes to the cost of our meds. 

Also, alot of the pharma companies have programs to help you pay for the drigs.  I would bet they could help you fill out all the paperwork at the onc's office.  My best friend's insurance wouldn't pay for her lovanox shots.  He put her on something that was more expensive but had a grant program.  The onc's nurse did all the paperwork and she had shots for a bout 6 months while she needed them, so maybe something like that is an option also.

sandyv

I thought the law was you have to give employee  30 days notice before cancelling any insurance, you may want check with your states Department of insurance... Thats the way it works in Texas anyway, worth a shot. Coverage would not be lost at all but you will have to pick up premiu

m which may be a lot more than what your spouse was paying.

brendaks

Just an FYI that the one time I had to use COBRA, I had to take my daughter into the doctor and she got an x-ray a couple weeks after it got enacted.  Several weeks later I got notified by the hospital that I owed the full amount because I had no insurance, even though I had sent the COBRA paperwork and payment in on time.

I contacted the insurance company and they tried to say they never received my COBRA paperwork or payment, but I was fortunate that I had mailed it certified mail, return receipt requested, and I was able to tell them who signed for it at their company and the date they received it.  They then suddenly were able to find my paperwork.

Lesson learned:  always send your COBRA paperwork and payment in a traceable way to hold up in court if necessary.