Did you know that your insurance provider has the right to withhold information from you, vital information that could save you some big money? I came across this article today on a Philadelphia news site about a young woman who was denied medical coverage through Aetna after she applied for individual health insurance.
After the 22-year-old Middletown resident was laid off from her job in December, she applied for an individual health insurance plan through Aetna, her employer’s small group health plan insurer. A company rep told her she should have no problem getting a plan since she had been an Aetna customer. – PhillyBurbs.com
Individual health care coverage is a completely different ball game, and providers are not required to follow the protective guidelines that are in the federal Health Insurance Portability and Accountability Act, which applies to group insurance plans.
With millions losing their jobs every month, many are trying to secure individual health care plans and affordable medical coverage, but according to Philly, studies suggest that some insurers reject at least 10 percent of applicants for individual coverage because of pre-existing medical conditions.
Aetna eventually told our unlucky heroine that it was possible to transfer from her group coverage to individual, but by that time it was too late. Aetna offers a conversion plan, that allows patients to convert to individual coverage, but it is costly and not as adequate as group coverage. In Aetna’s letter recommending conversion, a deadline was mentioned; 31 days after termination. The letter did not arrive until four months after she lost her job. Nice loophole, huh?
Our heroine eventually found health insurance…extremely expensive health insurance, but at least she is covered, unlike the 46 million Americans who are not.
Moral of this story: if you are about to lose your job and are thinking of converting to individual coverage, get all of the facts. Know what your deadlines are and make sure your provider gets you all of the information in time.
