I learned today that I don't have the right to an external review of my denied insurance claim because my plan is an...
I learned today that I don't have the right to an external review of my denied insurance claim because my plan is an old "grandfathered in" plan. If it was a new plan, "Obamacare" would have helped me. Since it's old, it doesn't. You might want to find out if you've got a grandfathered plan too.
https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/
Oh, good! I also learned that if my plan wasn't grandfathered the preventative appointment in question would have been covered in full no matter what! Obamacare specifically does away with the situation I'm stuck in.
ReplyDeleteThanks again, Obama!
So, would your plan have covered the situation at all prior to "Obamacare"?
ReplyDeleteI'm curious what "basically the same" means. I'll have to check my work insurance. The rates have changed, as well as some minor changes in coverage, but that might still be basically the same.
My problem is I took my kid to the doctor for his two-year checkup the day before his birthday therefore they don't have to cover it because he'd already had all his coverage for that time period. If I'd taken him one day later, there wouldn't be a problem. My insurance company won't fix this and I can't submit it for a review because of the grandfathering. Instead I'm at the mercy of their internal appeals process which I'm told by customer service is 99.9% of the time NOT in favor of the customer. So what's the point of an appeal, I wonder?
ReplyDeleteIf you're wondering you should call your insurance company. I just read there are something like 36% of people still in grandfathered policies.