I've had my insuance through my employer from october of '06. Money has been taken out of every paycheck to pay for the premium. I recently had an accident that required surgery and hospital stay in late feb. I have received three explanation of benefits from the insurance provider so far: 1.) for my ambulance ride which was covered. 2.) The first couple days with services shown as "Inpatient" and "Ancillary" which was covered. 3.) and a third peice of paper for the remainder of my stay for "SNFINPT" and "SNFANCIL" as the services provided but the third peice of paper states that I may be responsible for the bill because my membership was terminated prior to the date of service. I never received or heard anything from my employer or my insurance provider about my coverage being cancelled but my paycheck shows money being taken out for the premium up until the time of the injury. What rights do I have so I'm not stuck with this ridiculous bill? Any help would be great!
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Start with your HR person. Sometimes errors are made - either the premium payment was late and the entire company got cancelled - it's a HUGE pain in the neck, but it does happen. OR someone who's info is similar to yours was supposed to be cancelled, and they canceled you by mistake. As long as you can document (via your pay stubs) that you were paying your premiums, you have every reason to believe that you have coverage. Therefore, it was probably someone's mistake, and it needs to be rectified ASAP. BTW - contact the provider of service - the hospital and/or doctors to let them know you're fighting this so they don't think you're ignoring the bills.
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