Can Someone Sign Up For Health Insurance Retroactively?
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I am not lying, it is not a family member or friend…just curiosity! If a family with no insurance,for whatever reason, has no insurance, a member of the family suffers a catastrophic medical emergency, can that family sign up for obamacare? If so, do they pay a hefty fine and then be covered ? And does obamacare cover the recent Dr. and hospital bills for the recent catastrophic circumstance? Or are they out of luck ,so to speak?
Terri
My husband suffered a massive stroke (which later was discovered to be three) on Super Bowl Sunday (2.2.20).
He was taken to the nearest stroke facility to us in Newark, CA.
Most of the last 3 month, he has spent in the ICU and he is still hospitalized and has had many brain surgeries and procedures that were all stroke related since then.
My husband is a veteran, and used the VA as his only source for health coverage. He was with the same company for 35 years and was covered by the company the entire 35 years.
He has never been sick in his life. He did have a double hernia a couple of years back, with all costs completely covered by the VA. The hernias were due to the fact that he was a 70 year old man who played league basketball 3 days a week and we worked out (weight bearing) 5-6 days a week and that is what the doctors attributed the double hernias to.
He only had Medicare Part A at the time he was hospitalized, but subsequently I have been able to sign him up for Part B which will take effect 7.1.20. Over 30 days ago, the hospital told me his bill was already north of $3 million.
I’m reaching out to you, simply to ask if you have any suggestions, ideas or thoughts that may help my financial situation.
Thanks,
Terri
ObamaCareFacts.com
Hmmm, well Medicare Part A should have covered the hospitalization, although even then there is costs. But what I’m hearing is that there were a lot of uncovered costs that Part B should have covered. Now what you are also saying, I think, is that while he had VA and employer healthcare, and maybe this is why he didn’t have Part B initially, those were also no longer covering him?
In short, if he was supposed to have coverage, but didn’t and it wasn’t his fault, you have one avenue (appealing to those insurances he was supposed to have). If he just never signed up for Part B, this is tricker. In many ways you are just not in a good spot, you owe a giant bill, but have no coverage for it.
You can appeal some of this to Medicare, arguing the Part A should have covered more. You can talk to the hospital about options. And you can look into debt forgiveness programs and ways to get out of medical debt.
I think best first steps are talking to Medicare and the hospital about your options.
I think though this is a good example of why universal healthcare makes sense, and why the current complex system isn’t always idea. Got a hard working vet who should have had coverage, but didn’t because he didn’t pay the Part B premium and do the sign up. That is a little bit of bureaucracy that has now caused life changing issues. I am sorry.
Francis
Not entirely true. You can enroll for Obamacare and get retroactive coverage if you had a life changing event, like moving, losing your job, and other things. As long as the event happened 60 days prior to you need insurance.
Albert Cohen
Although the exact scenario of the question is not the same, it appears insurance companies are allowed to retroactively apply coverage. My wife and I enrolled in a plan on Jan 1st, 2016. Two months later (3/9), the insurance company terminated our policy. When asked, they said it was due to a missed payment but they then realized we were enrolled in auto-pay (and fully up-to-date) and they said it was due to the Marketplace (“something wrong” in our application). The Marketplace on the other hand still showed us as “active”, no sign of policy termination, no problem with the application. An escalation case was opened to reinstate coverage. Two months later (4/25), the coverage was successfully reinstated to 3/1. Having not gone to the doctor because of no coverage, this seems like a very good deal for the insurance company – 2 months of premiums without medical bills to pay. Just to make matters worse, today (5/2), the insurance coverage was dropped again. Reason given: something wrong with Marketplace application. On the Marketplace side, same story: shows us as active, nothing wrong, opening an escalation case. I expect that once all this is resolved, the insurance company will send a huge premium bill for all the months it decided “retroactively” to give us coverage for. I can’t quite see how health insurance can work retroactively: either you have medical costs or you didn’t, but once you know, what are your insuring against? Separately, in the event of a medical emergency, is the insurance company forced to cover it after all the paperwork problems they may be having with the Marketplace are resolved? Can they decide not to reinstate coverage at all?