What if you’re in a coma in the hospital when the premium is due?
Long Story –
Her prior coverage had lapsed for non-payment of premium as she states that she has memory loss due to her medical conditions. The Insurance Company** so far has told them that they won’t reinstate and said that they would send a grievance form for them to fill out. I found a standard grievance form and emailed it to my friend.
I don’t know how this will come out, but I looked all over the California Case Law section on FindLaw.com and so far have found nothing in the sister’s favor. The closest cases were on Life and Disability Policies that had a special provision at additional cost that will pay your premiums, if you are disabled for say 6 months or more. Under HIPAA, COBRA and other Insurance Laws, Anti-Discrimination, etc. they all allow cancellation for non-payment of premium.
Here’s a letter from an Attorney on a similar issue.
The only medical plan I can find for her at this point is MR. MIP, which is really great as it covers virtually anyone who for medical reasons can’t get Individual coverage, the down side was that they have a waiting list to get in.
So, the moral of the story is, make sure that you have a method to pay your medical premiums so that the Insurance Company can’t cancel you, when you need it the most!
Unfortunately, if you can’t remember to pay your premiums, you will probably have trouble working too. Check out Disability Coverage , if you have a Retirement Plan or Cash Values in Life Insurance you might be able to access that money. If all else fails the Government has various plans available. Healthy Families to cover your children, Medi-Cal if you’ve become poor, Social Security Disability – SSI which will qualify you for Medicare – after 2 years of disability and the Free Clinic.
*Name changed for privacy
**Insurance Company named not mentioned as we may be filing a grievance and as near as I can tell, all companies and HMO’s would cancel for non-pay, regardless of the reason.
No more reinstatements on late payments 1/1/2010
I knew that I hadn’t made my health payments through Blue Shield of Ca via Covered ca for a few months, but I failed to realize i had gone too long.
***Right. It’s 90 days if one is getting subsidies.
Previously I made payments easily with Health Net ,since I changed over to Blue Shield I have had issue logging in and being able to call in during business hours.
***Do you have a member portal?
Premium Due Date vs Automatic Bank Withdrawal
I have a question regarding on paying auto pay. It says my payments will be taken out every 23 of the month. When is my payments due? If I remember correctly you said it is due every 1st of the month?
The payment is due on the 1st of the month. Your coverage then goes into the grace period if not paid on the first.
I will check what options Molina has for the withdrawal date. Here’s a link to the various ways to pay your premium with Molina. Here’s the Molina Member Portal. Create an account and see if you can change the auto withdrawal date. It might be that the 23rd came up as you are doing the first payment on the 17th…
Reply from Molina
The Autopay is not set-up to allow member to select a payment due that they wish, the 23rd is in place to ensure payment is received and applied for coverage for the following month-it is clearly stated in the Terms and Conditions when enrolling. (see below)
Here’s definitions from a specimen policy on when the premium is due.
All Monthly Premium Payments and administrative fees are payable in advance and due on the Monthly Premium Due Date. The Monthly Premium Due Date is the first day of the Plan period for which we receive Premium Payment. For example, if the Plan Period is March 1 to March 31, the Monthly Premium Due Date is March 1. The Plan Period is not affected by and does not affect the use of other periods of time to measure or determine Your rights and benefits, for example, the use of the calendar Year as applied to Deductible, or the use of the calendar Year to determine maximum Copayments/Coinsurance – Page 32
For Your convenience, You may authorize us to automatically deduct Your Premium Payment from Your financial institution account every month. To learn more about this option, contact customer service. Page 33
The grace period for payment of future premiums is thirty (30) days from the Monthly Premium Due Date. If You fail to pay premiums as they become due, xxx may terminate this Agreement as described below as of the last day of the grace period. Page 39
Proof of an Automatic Payment?
1. My credit card was on file with Anthem Blue Cross Platinum PPO for monthly payments of my premium. I do this with all of my insurance plans: house, health, and car. I have never had a problem.