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JRZane t1_j1ua074 wrote

obviously I dont know your issue, but there's something odd going on here. The only way a company can legally "drop" a customer mid-year (not during open enrollment ie. end of the benefit year) is bc of not paying the premium. Even then, there's a grace period where if a person catches up on premiums it's as if no lapse in coverage occurred. They also MUST send out letters stating premiums are behind and provide a deadline date.

At my practice we get these letters all the time. like, weekly. Patient A has been coming in and we receive a letter stating "Patient A hasn't paid their premium, if its not paid by Date X claims from (date to date) won't be paid."

Please dont read this as not believing you, what im saying is knowing the regs a little bit gives you some leverage so you aren't surprised as you mentioned. There are also programs to cover kids, even if you have reasonable financial means (CHIP), and it's backdated. So if your kid didn't have coverage starting Feb 1 and he/she I admitted into hospital Feb 15, CHIP will cover the costs 90 days PRIOR to claim. Most hospitals have a social worker that will help with application. Now, its a low-paying plan and they will still try and get you out quickly (hospital soperate in the red with CMS rates and need commercial plans to stay afloat), but you won't be on the hook for monster bills.

https://www.insurekidsnow.gov/coverage/nj/index.html

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OkBid1535 t1_j1utvgy wrote

When we were in the hospital absolutely no one there was willing to work with us or discuss other options. No one even mentioned CHIP to us. We had NJ family care years ago but since priced out of it basically.

We again had auto pay set up and paid our premiums. We’ve had to pay hundreds and thousands out of pocket and certain appointments after finding out we’d lost insurance.

It’s been hell. And the worst part is, it isn’t just us. We’ve multiple self employed friends using BCBS, set up for autopay and same thing. Punished for paying on time and coverage is dropped. There was even a huge lawsuit circulating for people to sue horizon because it’s been getting so bad.

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