Can medical insurance legally back date the cancellation date and leave unpaid bills?

  • by ?
  • Apr 25,2018
  • 13 answers

I recently lost my medical insurance due to not being able to pay my premium. It was terminated in March but then I started getting bills from doctors that I saw in Jan and Feb. I called all the billing departments and they said that I was "active and covered" when I was treated but once I lost insurance they back dated it to Jan 1st and left THOUSANDS OF DOLLARS of unpaid claims for everything from hospital visits, cardiologist appointments, primary care doctor appointments and much more.
Any help would be appreciated. I don't know what else to do.


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Insurance Answers (13)

Casey Y 5 months ago

They send you letters about the policy...read them.
Sounds like you never renewed your policy in 2018...when was the last time you paid them??

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lucy 5 months ago

IF in fact the last payment you made was in January, then should have coverage till January 31, 2018. But the question is, was the January payment for December 2017 or January? If you have been paying the premium late, then that last payment could be for December.
Insurance companies many times (assume) that you will keep making payments, thus expected you to pay any past due to (keep) your insurance. I changed insurance in January and my (old) insurance sent me a new ID card and billed me. I called them to inform them that I had (changed) insurance and they still kept sending me letters and bills for 2 months, till they finally gave up.
Health insurance is paid (monthly) for (each) month. So if you did not pay the premiums for (each) month that you sought treatment, then you had NO insurance, thus will owe for your medical bills.

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curtisports2 5 months ago

It was terminated in March. Most policies don't terminate immediately, they terminate after the premium has gone unpaid for a certain amount of time. Maybe they terminated in March but you were only paid until the end of December, so technically, you had no coverage in January. We can't possibly know without seeing the policy paperwork. Find out the last day your premiums were paid until, and any service or procedure you received before that day, you are covered for. If you were actually paid until February 8 and were terminated March 1st, then what the insurance company did is illegal and if the service providers assisted with falsification of the records, they're in just as much legal hot water as the insurance company.
So, find out what the last day your premiums paid to was. Then, if it looks like you were cheated, contact an attorney.

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? 5 months ago

Yes

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DON W 6 months ago

Sounds like you were gaming the system, knowing that you hadn't paid and wouldn't be able to pay, but wanting to get some work done before the insurance company caught on. Didn't work for you.

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Eva 6 months ago

They wouldn't backdate your policy unless you hadn't paid the premiums for January and February. If you didn't pay, then you didn't have coverage.

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Insurance Pickle.com 6 months ago

Yes, that's correct and how it works. You have a grace period to allow you time to pay the bills so your coverage isn't interrupted. But, if you ultimately don't pay, then the coverage is only good through when you paid. It wouldn't make sense for them to cover bills you had in January if you never paid for coverage for January. They're not really backdating insomuch as they're correcting it to make it right. I'm sorry this happened, but it is ultimately on you to know to only use the coverage for the months you're paying for coverage.
Best bet at this point is to set up payment plans with the providers.

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StephenWeinstein 6 months ago

Medical insurance MUST backdate the cancellation to the date after the last day for which you paid the premium (which was probably December 31). They CANNOT legally pay for any treatment that you received after that date. If you didn't pay the premium, then they cannot legally pay the claims. You must pay the bills yourself.
It doesn't matter that they said on the phone that you were "active and covered". That only means that you had been "active and covered" on the most recent date for which they can tell whether you were "active and covered". They can't tell whether you still are still active and covered, until weeks or months later.

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Flower 6 months ago

If you were covered until March, you were covered in January and February. So you didnt have to be "back-dated" because you were actually covered in January and February. So why didnt your insurance pay?

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Steve D 6 months ago

Depends on when you stopped paying the premiums. If you stopped paying premiums back in December, then they weren't backdating your coverage since your had not paid it. What they were doing was giving you a grace period to get your policy up to date. Thus, it showed up at in force, but it actually wasn't. Try contacting your providers and see about discounts and payment plans.
If you had paid your premiums through February, then you should have been active and covered.

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Hug 6 months ago

Possibly not

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Pascal the Gambler 6 months ago

When did you stop paying? If you hadn't paid since January, then they probably can.

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acermill 6 months ago

They did not backdate your cancellation. They dated it to the period for which you last paid. That it showed active at your healthcare providers is not any sort of guarantee that coverage is in effect. All you can do is ask your healthcare providers for a payment plan, and perhaps a reduced price.

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