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You are here: Experts > Industry > Health Plan > Health Plan Administration > Lapse in coverage ?
Expert: Linda Woolsteen - 10/28/2009
Question
Hi Linda. I have Blue Cross of Ca. medical insurance and have had it for 25 years. I was recently late with my payment but my insurance was never canceled. My insurance pymnt was due sept 27th and I finally got it there around the 15th of Oct. I called Blue Shield and was going to pay it with my debit card before the 27th of sept but they said my insurance wouldn't be canceled untill oct 22 for non payment. As luck would have it ended up in the emergency room on Oct 1st and ran up a large bill of $3620. I have been informed by Blue Shield that my coverage wasn't in effect at that time. I had no idea of this. I thought since they told me it wouldn't be canceled untill the Oct 22nd I was covered. Isn't there a grace period on medical ins? Or am I totally out of luck here? I wanted your opinion before I contact Blue Shield. Thanks, Dan
Answer
Hi,
I apologize for the lateness of my reply. I had some medical issues of my own this past week and wasn't online very much.
Anyways, you are correct that there is usually a grace period. It is usually 31 days. Most polciies are due on the 1st not an odd date but sometimes, individual policies may have their own specific due date as you are saying it was due on 9/27/09.
I cannot really say unless I read your policy. But, if your actual due date was 9/1/09 then you had 31 days you should have paid by around 9/30/09 or maybe even 10/1/09 to keep your policy in force. You say you paid on 10/15/09, if that is correct and your grace period only took you to the end of September then they can deny your claim with a Date of service of 10/1/09.
Since you have been a long standing customer of theirs. I would appeal. You usually must state on your letter and I would do it in big bold letters "APPEAL" and then indicate what you told me. That you have been with them for 25 yrs. and did call and tried to pay but was told by a Customer Service Rep that it would not cancel until 10/22/09 and with that you would hope that they will help you out by reinstating your policy and considering your claim.
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