If I’m currently insured, but cancel my policy a month after my doctor’s visit, will the insurer pay for that visit?
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Asked April 16, 2012
The confusion here arises from the fact that many medical centers do not bill immediately. Hospitals are notorious for billing anywhere from 1 to 3 months after the initial visit. Since your policy would no longer be in effect at that time, it is easy to understand how you could be worried about whether your coverage will pay. The good news is that insurance company will look at the date the treatment was received, not at the date when the bill is received by them.
As long as your health insurance is in effect at the time of your medical treatment, it will pay for any covered expenses related to the treatment. As long as the medical attention you receive is covered by your current insurance plan, the bill will be paid when it is received even if you are no longer a part of that insurance plan.
However, there is another consideration that you should be aware of. If the medical treatment becomes an ongoing situation which extends beyond the date of your policy cancellation, your current coverage will only pay for treatments received up until the policy ends. Furthermore, your new health insurance provider will not be obligated to pay for the treatments after your new policy goes into effect unless preexisting conditions are specifically mentioned as being covered. Since you already had the problem when you applied for the new coverage, you may have to pay for all of the costs after your current coverage ends out of your own pocket.
By 2014, all health insurance companies will be required to honor medical treatments for preexisting conditions under the currently legislated healthcare reform, but many companies have not yet adopted those rules. If you have already begun shopping for your new health insurance plan, it might be a good idea to find out whether the company is already in compliance with the healthcare reform, or to shop for another carrier it your first choice is not compliant. That way, even if your treatment extends beyond the termination of your current policy you will still have the coverage you need.
Answered April 16, 2012 by Anonymous