Can Insurance Cancel Me in the Middle of Treatment?
Can my insurance (Horizon New Jersey Family Care) cancel me in the middle of treatment, they say I do not qualify anymore for the insurance because of my disability income, but I am in the middle of physical therapy. the card is currently working all I got was a letter. with a pass date of cancelation, for 02/17/2015 it took 7 weeks to even get a disability income. and I have had a large about of doctor appointments since that past date they wrote, they said I am now responsible for the bills, and that I can just apply for Obama care. it all sounds incorrect, and I have a surgery for 04/06/2015. so I am confused, can I get canceled in the middle of treatment, its for carpal tunnel I can barely use my hands can they just do that, cancel treatment for my hands and just have me get another provider????
Answer
A private insurer can't drop you mid-treatment for any reason other than non-payment of fraud, however one could lose Medicaid mid-treatment. Medicaid is based on monthly income, in the month where your income increased you could become ineligible for Medicaid. The proper thing to do would have been to enroll in a Marketplace plan to avoid gaps in coverage.
This is a BIG fail on behalf of the healthcare system. The way the system communicates with people is really messed up, they should have helped you transition to avoid a gap in coverage. There is no good way to fix this, but you should probably appeal this. The truth is the medical debt you are about to be stuck with will most likely result in offsetting disability income and thus leave you eligible for Medicaid again. That is completely broken and is simply costing the state of New Jersey money, while completely doing you an injustice.
New Jersey: NJ FamilyCare Agency name:
Division of Medical Assistance and Health Services Fair Hearing Unit You have 20 days from the date of your Eligibility Determination Notice to file for a fair hearing.
Hotline for assistance: 609-588-2655 Hours of operation: Monday – Friday, 9:00 a.m. – 5:00 p.m. State agency website: http://www.state.nj.us/humanservices/dmahs/home/index.html
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Answer Rating:
it makes to sense, i keep, qualifying and not qualifying week by week. the insurance still works currently, my disability ended the 2nd of this month, i did call and write for a hearing,no one has callecd or replied. i am back to disabled and no income, reapplying for disability or a continuation, that can take 2-6 weeks. took 7 weeks the 1st time. i had no income so i qualified for medical, i got 1 check for 8 weeks i no longer qualify, and my disability ended, so i paid my mortgage and so i am back to no income. its like a ping pon game, except with my physical therapy. i call the insurance before every appointment to see if its active. its a mess.
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and every time i apply on the marketplace they say i don’t make enough income, to try applying for welfare. so too much income to medicare, no enough for the marketplace?! but i can get food stamps…. its very WTF. but here is a fine at tax season for not having insurance lol.