I am covered through my dad s insurance ( I am 18) and for the past few months I ve been shown as inactive. My dad and his wife are able to get coverage but all my health claims are denied and I m told I m not even on the insurance, however when I call the insurance I m told I m active and they haven t received any claims. (I have a sister who goes through a different doctor and is having the same issue) I need an MRI because I might have brain cancer and keep having seizures, but no one will give me an MRI without insurance and no one is trying to help me, I have blue shield by the way, what can I do to fix this??
babyboomer1001
Go to the doctor and ask the receptionist to verify that you still have the insurance. She will let you know.
StephenWeinstein
It is showing as inactive because it is inactive. If they said on the phone that it is active, that confirms that it is probably inactive, because accurate information is usually not given on the phone. If you are told on the phone that they haven’t received any claims, that only means that they haven’t received any claims that they want to admit on the phone. Unless information is given in writing, do not believe it. Believe only what you see on paper. Believe nothing on the phone.
A Hunch
Did your dad’s insurance change so that your doctors are no longer on the plan?
Did the doctors change what coverage they accept?
Did your dad drop your coverage?
Are you sure that you are providing the doctor’s office the correct information?
Is there an error that dad needs to fix?
It’s one of those situations… figure out which one.
Good luck.
lucy
There is only 1 explanation that would make sense and that your father dropped both you and your sister off the policy when the policy renewed be it at his employer or at the 1st of the year on the exchange. Think about it, your dad and wife are covered, but not you or your sister.
With the new law, the parents can insure their children up to age 26, but that is an (option) that the parent can (choose) to do and pay for it. But at age 18, then in “effect” you are an adult, so like child support can be stopped.
Shouldn’t you have a ID card with your name and your dad’s name with the insurance company ID and policy number? It has been years since I had regular insurance since I am old/retired, but I “think” I remember getting separate ID cards for my (late) husband and my kids. Or in years past after I lost my employer insurance and both my (late) husband and I got a private policy, then we would get a copy of it, showing both our names and the effective date of the policy. How can the insurance say you are active but have received no claims, yet the doctors tell you that the insurance denied to the claims to be inactive?
Or as one poster stated that even though both doctors accept blue shield, they may (not) accept the plan that your dad has. Or, those doctors could have accepted the insurance in the past, but when it renewed, then the insurance and these doctors did not agree to be in the plan, thus denied. Thus if they don’t accept the plan your dad has, then they may have (not) submitted the claim to the insurance. If insurance denied, then the bill that both you and your sister got should show on it that on (such and such) date submitted to Blue Shield and denied it.
My guess is that (before) the MRI that you make sure that the doctor/provider gets a pre-approval for it, so they will know that you are covered. Otherwise I can see the MRI place demanding payment in advance (before) they do the MRI, or refuse to do it.
Good luck, since you will need it to straighten out this mess.
Elaine M
The phone number you have for the insurance company should be given to the clinic when you’re there and have them call the insurance company. Make a trip down to the place you’re using and tell them you’re there to get this straightened out in advance before the MRI can be scheduled. WAIT there while the person calls and updates your file, this should clear things up.
Mamawisdom
Your father — the primary policyholder — needs to get on the phone and find out what is going on. Your post is unclear because you didn’t state WHO was telling you that you are not covered and who is telling you that you are. Is the MRI facility, hospital, or doctor is calling your insurance provider and getting told that you ARE covered or that you are NOT? Do you know what type of policy your father has for you? Is it up-to-date? Get dad to get on this for you.
Judy
Do you have an insurance card that shows your coverage? Ask the insurance company to send you one.
Casey Y
Your father needs to resolve this. He needs to get on the phone and find someone who can help…might take hours on the phone, but that’s the world in which we live.
Flower
Ask your Dad to call his insurance agent and find out why you are not active on his policy. Meanwhile, if you cant pay for a doctor, you can go to a city or county health clinic for a lower fee. Did the doctor submit the claims and did you tell doctor what insurance said? Perhaps the doctor does not accept that particular plan even though they accept that insurance company.