I had some health services completed 4 years ago. Can I request that my health insurance company pay for it?
UPDATED: Mar 5, 2013
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Asked March 5, 2013
As with most contracts, your health insurance policy probably contains a clause which defines how long you have to file a claim. Most insurance companies will allow you up to one year to file a claim, but the time limit may be much earlier, such as 6 months or even 90 days. Read your policy or contact your health insurance carrier to find out exactly what the deadline for filing the claim is.
Different types of health insurance claims may have different deadlines. For example, a medical procedure may have to be filed within 90 days, while a claim for medical equipment could be extended to 6 months. Each company is different, and even the same company may have different rules from one state to another. It may even be a case where the insurance company will pay the bill, but only if it is filed through the medical billing office of the care provider.
If you are unsure about state regulations, you can contact your state's department of insurance and ask them specific questions about licensing and company regulation. The department cannot give you information regarding your specific policy, but they can help you understand the regulations of your state of residence.
You cannot file a claim from several years ago against an insurance company that did not cover you at that time. For example if you recently changed insurance agents, you cannot file an old claim against the new carrier. They may provide coverage for preexisting conditions, but will not honor preexisting bills.
Answered March 5, 2013 by Anonymous