Is a health insurance company allowed to place a treatment deadline on a pre-certified treatment?

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Is a health insurance company allowed to place a treatment deadline on a pre-certified treatment?

If so, what are the parameters? Yesterday my health insurer approved a procedure it previously denied, however t requires that it be done before the end of the month but doctors are taking holiday time off.

Asked on December 9, 2014 under Insurance Law, Indiana

Answers:

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

Answered 6 years ago | Contributor

Generally yes, and state law as well as your insurance contract would state what those parameters are.  But it does not mean that you can not extend the parameters on explanation and consent and you should request that from your insurance company - both you AND your doctor.  And confirmation from them should be in writing.  Good luck.


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