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It sound like the employer is self-insuring a portion of the plan and they no longer want to pay the expense. (I would find out if it because the son maximized the benefit or if something illegal is going on.)
Ex: Company XYZ provides employees medical insurance through United HC. The company opts to self insure medical expenses up to $40,000. Thereafter, the insurance company pays as indicated in the plan. The insurance company will process all claims and "bill" the employer for the first $40,000.
Usually, employees do not know about this because plan benefits are paid accordingly. Your company could be paying, but because it is processed by the insurance company, it is not transparent.
Yes it's United Healtcare PPO. You pay into it from your paycheck.
The dependent is 17 and it's for behavioral health.
She said they didn't tell her why....just they it was completely covered and then her company sent a letter to United that they know longer will pay for it.
This could be your reason right here. Mental health coverage always has a cap over a certain period of time whether inpatient or outpatient. She may have reached the limit.
The question you should be asking is not "can they" from an Internet message board where people don't know all the facts but rather you should be asking "why?" of the employer. The medical facility usually won't know why benefits have stopped. They are not responsible for keeping track of every patient's coverage.
Also, you can read the insurance policy or synopsis of coverage which will tell you if this is the case regarding his coverage. These things are clearly spelled out on the list of benefits and limitations.
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