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crystallinectar, atheist hippie | I just got a letter from my insurance company? |
regarding a trip to the emergency room i had in may.
it says "if you had recent health coverage, your prior company should have sent you a "certificate of health plan coverage" please send a copy (ies) of this certificate which indicates the amount of creditable coverage from your prior health plan(s). This will be used to determine any pre-existing limitation"
what in the world does this mean? it's insurance we have through my husband's work. we got married in august and the insurance didn't kick in until october. so from august 5th to october 28th, we had no insurance and before that we were each our parent's health insurance.
i have no certificate and neither does my husband.
the letter also says if we don't send this info within 45 days, they'll deny our claim.
i can't call the insurance people until monday, and i'm freaking out about this. (it's a 3000 dollar bill that i can't afford). does anyone have any idea what i'm supposed to do?
Additional Details
i had no preexisting conditions--the trip was for a cyst that burst on my ovary. so i just need the old insurance to tell them that wasn't related to some condition i already had? |
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Zarnev
 |
You can contact the prior insurance companies to get the certificate. However, you did have a lapse in coverage of nearly 3 months so if the medical bill is for something that is pre-existing the company may still deny the claim.
EDIT FOR ADDITIONAL DETAILS:
Since you had no pre-existing conditions you have nothing to worry about. Go ahead and call your previous company on Monday to get the letter, that will probably satisfy your current company. If it doesn't, it is up to them to get medical records to prove otherwise. If they give you a hassle about paying the bill you'll have to go through the appeals process but that is a different question and answer. |
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Landlord
 |
Call on Monday. All this really means is that htey are hoping to share the bill. A call is all that they need, |
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David W
 |
When you sign up for insurance, you are subject to a pre-existing conditions exclusion. For a specified period of time, they won't cover something you already had when you enrolled.
If you replaced coverage, the pre-x is often waived to the same extent it was satisfied under the old coverage (required by law). They are asking you to demonstrate that you had coverage immediately before enrolling in their plan. So contact the old insurance and ask for the statement of creditable coverage - it's how much "credit" you get toward the pre-x on the new plan.
Or don't. They can deny the claim because you refused to follow the plan requirements. |
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KicktBak
 |
A certificate of health plan coverage gives a general rundown of any pre-existing conditions you had at the time you initially signed up for insurance coverage. The insurance company basically wants to know if you had any other coverage, and if so - whether or not you had any conditions that existed before your trip to the emergency room. It's just their way of making sure they don't pay for anything that was already wrong with you before the need to visit the ER. They only want to pay for things directly related to the ER visit. |
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T I
 |
First: Relax.
Second: Don't worry about finding the form they want. More on this in a minute.
Third: Call your parents and get the policy numbers for the policies you both were covered under.
Fourth: Call your insurance company and give them the policy numbers. Let them do the legwork.
Fifth, relax. All they are doing is making sure they don't pay a claim they don't have to pay (if your treatment was for a true emergency, this is probably just a formality). It wouldn't hurt to have your husband speak to someone about it in the office where he works; they can be a lot of help.
Remember: you have a month and a half to do this. Go ahead and do it to get it off your mind, but everything is going to be fine. It can be intimidating, dealing with insurance companies, but you'll learn in time that most of this kind of thing isn't nearly as threatening as it seems. |
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sunshine_today
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contact the insurance you were covered by during that time period and ask them for that letter. It's not a big deal. chill out. |
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Insurance
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this is a common process that insurer will check for any pre existing condition before they pay out.
1. call them on monday and explain your unique the situation.
2. if required, you may need to contact the previous insurer
3. Get your insurance agent to assist you |
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Nightrider
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No need to freak out. This is just a ploy to collect either money or all your personal info.
Just sit on it. Let them sweat a little if it is really legit.
You will find out soon - I am willing to betcha - it is a scam. |
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