AmI responsible for medical bills if my doctor’soffice checked my eligibility prior to the visit and I came up active in system?

UPDATED: Jul 9, 2011

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AmI responsible for medical bills if my doctor’soffice checked my eligibility prior to the visit and I came up active in system?

My union sent me a letter about the Obama law regarding my son (20) as a dependent on my plan. It had to be returned by a certain date, which I did. Subsequently my son and I went to the doctor’s office. They checked his eligibility and he came up active. They took blood work. About a week or so later, we went back and they again checked eligibility and again it up active. They did more blood work, plus a sonogram. However I found out that out that they never received the letter that I sent and terminated my son prior to our first visit. Now my son who has been on my plan for 20 years is terminated with no letter, email or phone call. OK fine, but they left him active in system so when I went to the doctor’s office and he came up active. I thought all was OK. Am I responsible for these bills?

Asked on July 9, 2011 under Insurance Law, New York


M.T.G., Member, New York Bar / FreeAdvice Contributing Attorney

Answered 11 years ago | Contributor

First of all calm down about the matter ans you need to call your Union and get them on your side to help asap.  If you sent in the form and they just don't have it then you need to fight them on this.  As for the bills, when you go in to any doctor's office they have you sign an agreement that states that if the insurance disclaims for any reason you would be responsible for the payment.  I am sure that you signed one for your son.  So although he is an adult and technically he is responsible for the bills (but really are you going to allow them to ruin his credit by going after him at this young an age) you probably signed for them.  So they have a basis to go after you.  Now you are going to argue just how you presented here: that they confirmed coverage rior to treatment and that you would not have treated him otherwise.  I tell you it probably will not work.  So get on your Union, file a compalint with the NYS Department of Insurance and get the coverage back.  Good luck.

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