• Insurance Carrier: Humana
  • State: IL

Consumer Complaint:

I’ve had my insurance through my employer from July 2007. My employer pays for it; the money has not been take out every paycheck because we have like a group insurance. I had my surgery in September and all my medical bills were sent to my insurance. They have paid for them but in a next few days they started to cancel them. I was shocked. Why? I called them and they told me that my insurance got cancelled by the end of August. They gave me an authorization number for the surgery, how come? Did not they know that I am not going to be cover in September? I called them and I was told to talk to my employer. So I did talk to my boss a hundred times and he said that he was not aware of it. I cannot wait too long because they are going to send me to collection. What should I do? Please advice.

Insurance Expert Answer:

I have no idea who your employer is or what's going on with your employer -- especially in this economy -- but it almost sounds as if either (1) the employer stopped paying for the health insurance premium and never told you or (2) the employer switched insurance companies and plans and you've recently been dealing with someone at the former insurance company or using an old plan ID number at the carrier. Until an insurer is aware a policy lapsed -- and sometimes it takes until the end of the grace period to pay premium or beyond -- the insurer's call center would continue to say to you and providers that according to its records you are enrolled and the treatment would be covered. But when the bill for your services comes in weeks or months later, the insurer will not pay the claim if the premium payment hadn't been made by the employer. We'd suggest you go to the employer's benefits people or your supervisor and ask if the same health insurance policy has remained in force; if so it just may be a foul up at the insurance company and the employer should help you straighten it out directly or through the broker involved. If the employer says \"shucks, I forgot to tell you I couldn't pay the premium and keep paying you\" then the lapse date would be crucial -- to see what the lapse date is would require a reading of the policy, and knowledge of state law and insurance department regulations as to what happens. In that case you should try to contact the Illinois Insurance Department, but as it is premature until you know what is going on, I'd suggest that you have a real talk with the person who handles the insurance benefits at the employer and get the facts.