PLEASE PLEASE help - if you are familiar with, COBRA, Health Ins., Work in HR...

I am so at a loss right now. I am 39 wks pregnant and scheduled for a C section on Thursday morning.

I was laid off last year and have been on COBRA. We've only had to pay the unsubsidized amount up until now and through March, have received bills for that amount only.

I just found out TODAY, only after a friend at my old office came across a letter from the Ins. Co. to my old employer, that the amount that they billed us for Jan, Feb and March of 2011, which we paid, was incorrect.

The amount they billed was about $500 (which has been the same for the past year or so), however, the letter to my old employer basically says - oops, it should've been $1,500 because the subsidized portion ran out.


So the Ins Co. took it upon themselves to credit my employer's account and apply all 3 payments that we made to January and now they are claiming the balance of $3,000. is owed for Feb and March.

To make matters worse I also found out yesterday that there are new deductibles and we would have to pay $1,500 for the hospital stay as opposed to what used to be $200.

So, I received bills for X and paid them with the understanding that our bills were going to be covered. Now they want more $ after I've seen all my Dr's. Had I known in January that the rates and deductibles went up so much, I would have had the chance to shop around for a new plan.

I never received notice of any of this and still without my friend calling me, would know nothing.

The Ins. Co won't discuss any billing matters with me because they are only authorized to talk to the one person in the office who is in New Orleans.

There may have been an option to terminate coverage from this Ins. Co. effective March 1st and go on my DH job's ins plan, but I just found out that none of my Dr.'s accept it (including all the specialists that I've already seen this month).

So, I'm not sure what my options are at this point.

I'm scared that my coverage will be terminated if not paid. I'm scared to to get stuck with a hospital bill for tens of thousands of dollars.

My friend spoke to the Ins broker who pretty much said that it was just billed in error and that the employer should have known and it's on them. But I know they will not take care of it...they are HORRIBLE...they never gave me notice of any of the terms of cobra, I just had to call my friend when it started to find out when and how much I needed to pay.

In all fairness to them though (employer), they were not billed the right amount from the Ins Co. either.

Thank you if you've read this.

I'm a mess right now as the baby has been measuring small MUST be delivered in the next couple of days. I don't know what to do shy of getting the new policy through DH's plan, and having another Dr. deliver me (if that's an option), but I'd have to see how much all the specialist's bills from March would cost

Message edited 3/22/2011 8:27:23 PM.

Re: PLEASE PLEASE help - if you are familiar with, COBRA, Health Ins., Work in HR...

Dana!!!
First of all your preview employer HAD to notify you about Cobra...its against the law not too...

I dont know too much about Cobra but ugg..is there NO one you cn talk to at all there? SOB's!!!!!

Re: PLEASE PLEASE help - if you are familiar with, COBRA, Health Ins., Work in HR...

I know nothing about cobra but if that doesn't work out,you should find out whether your dhs plan has out of network coverage and if so what is the deductible?

Re: PLEASE PLEASE help - if you are familiar with, COBRA, Health Ins., Work in HR...

Re: PLEASE PLEASE help - if you are familiar with, COBRA, Health Ins., Work in HR...

Sorry you are dealing with this

A couple of things:

1) The COBRA subsidy is supposed to last for 15 months. So if you were laid off sometime last year, then your 15 months would not be up yet & you should not be responsible for the full COBRA payment. What date were you laid off and when did COBRA start? Instead of speaking with the insurance company, is there a COBRA administrator that you can speak with? They may be able to better explain the situation than your employer.

2) As a COBRA participant, you are supposed to be treated as an active employee - so you should have been given notice of the plan & premium changes and been given the option to change or terminate coverage. You definitely can file suit against your company - sounds like they dropped the ball.

3) More importantly for your situation though - there is transition of care available if you switch to your husband's plan. Transition of care allows your doctors & facilities that are in-network with your current plan to be treated in-network with the new plan. It needs to be approved by the insurance company but this is an option that is commonly exercised.

I am very familiar with COBRA so let me know if you have more questions.

Re: PLEASE PLEASE help - if you are familiar with, COBRA, Health Ins., Work in HR...

There is a ton of information on COBRA on this site:

COBRA

Re: PLEASE PLEASE help - if you are familiar with, COBRA, Health Ins., Work in HR...

Posted by alisha

Sorry you are dealing with this

A couple of things:

1) The COBRA subsidy is supposed to last for 15 months. So if you were laid off sometime last year, then your 15 months would not be up yet & you should not be responsible for the full COBRA payment. What date were you laid off and when did COBRA start? Instead of speaking with the insurance company, is there a COBRA administrator that you can speak with? They may be able to better explain the situation than your employer.

2) As a COBRA participant, you are supposed to be treated as an active employee - so you should have been given notice of the plan & premium changes and been given the option to change or terminate coverage. You definitely can file suit against your company - sounds like they dropped the ball.

3) More importantly for your situation though - there is transition of care available if you switch to your husband's plan. Transition of care allows your doctors & facilities that are in-network with your current plan to be treated in-network with the new plan. It needs to be approved by the insurance company but this is an option that is commonly exercised.

I am very familiar with COBRA so let me know if you have more questions.

Message edited 3/22/2011 9:59:38 PM.

Re: PLEASE PLEASE help - if you are familiar with, COBRA, Health Ins., Work in HR...

Re: PLEASE PLEASE help - if you are familiar with, COBRA, Health Ins., Work in HR...