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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.
EXACTLY! All she has to do it call the customer service number for the insurance company and they will tell her why it's not covered. However, I'm pretty sure they probably met their max payout for mental health. Most insurance companies do have a cap for this type of treatment and coverage stops when reached. It has nothing to do with pre-existing conditions (which have to be covered by all companies now). If they can't afford the treatment out of pocket then they will need to find an area hospital that treats mental health patients with no insurance coverage. Typically each county has at least one.
In my state, ANY cancellation of insurance MUST follow up with a notification within five days of termination.
My current employer ( hired two months ago)...got snippy because I didn't sign up for their insurance. They had me sign a release that it was offered. Then they "expected" that I show proof of insurance thru my other provider. I politely told them its not their business to know. There is no Federal mandated labor law that requires I must show my employer such. Of course there is no labor law that says I have to have taxes deducted from my paycheck. Just a law that says I have to pay taxes on income or assets.
In my state, ANY cancellation of insurance MUST follow up with a notification within five days of termination.
My current employer ( hired two months ago)...got snippy because I didn't sign up for their insurance. They had me sign a release that it was offered. Then they "expected" that I show proof of insurance thru my other provider. I politely told them its not their business to know. There is no Federal mandated labor law that requires I must show my employer such. Of course there is no labor law that says I have to have taxes deducted from my paycheck. Just a law that says I have to pay taxes on income or assets.
I don't think this person insurance was cancelled. They probably just met their max on what their insurance will pay for mental health coverage. The OP's friend probably doesn't understand that. A simple call to the their insurance company could clarify things.
Also, by law with the ACA, your employer has to have you sign a release showing that they offered you health insurance and you declined.
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.
Something seems wrong here, and perhaps she isn't telling the whole story.
It sounds like his policy for mental health coverage has capped out. Whatever the reason, they need to get it in writing. If they don't, his State's Insurance Commissioner needs to get involved.
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.
Did she hit the limit for mental health coverage? That's usually covered at a lower limit than regular health issues. Read the coverage documents.
She said United Healthcare told her that her employer sent them a letter to stop payment I think. So now she is talking to HR and said her company can be liable since her son had to be abruptly taken out of a residential facility after 3 weeks. If she didn't get him she would be charged $1500 a day. With all the time she has taken off I'm surprised her company hasn't let her go.
i think somebody or whoever is int he hospital is lying to you.. A employer cant make a insurance company stop paying unless the employer remove them from the insurance and they stop paying..
Maybe there is a maximum the insurance will pay for mental health or for any kind of residential facility. My Dad reached the maximum after brain surgery, and we had to bring him home.
There is no maximum anymore thanks to ACA
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EXACTLY! All she has to do it call the customer service number for the insurance company and they will tell her why it's not covered. However, I'm pretty sure they probably met their max payout for mental health. Most insurance companies do have a cap for this type of treatment and coverage stops when reached. It has nothing to do with pre-existing conditions (which have to be covered by all companies now). If they can't afford the treatment out of pocket then they will need to find an area hospital that treats mental health patients with no insurance coverage. Typically each county has at least one.
