Summary: It's all about the group that the company choose and then terminated without leaving recourse for unpaid claims. Since they are out of business, you'll be stuck with it. It's not your fault, it's not Meritain's fault, it's the company's fault and since they went out of business, good luck trying to get any funds from them, but that is who should be responsible for the bill. Since your husband's company is no longer existing, I hate to tell you that you're going to be responsible for the bill. Most companies will "Opt In" and thus, your claims would be covered as long as they are submitted in the time limit (usually 90-120 days), if they "Opt Out" that's because the NEW insurance company that is coming on board with the company will agree to accept any claims from the past that were not paid by Meritain. When they stop paying the premiums, the company had a choice to "Opt In" or "Opt Out" of past claims. So check it out, basically the company paid as a group to Meritain. Oh, oh, oh, I KNOW this one!!! I actually JUST had/have a patient with Meritain going through the SAME thing (Arizona.you?). TL DR: My old insurance won't pay for an anatomy scan that happened under their watch, saying they don't have to cover me because my husband's company stopped paying them for insurance (after the date of the ultrasound). Meritain says that the only way they'd be able to process the claim is if my husband's company, which doesn't exist anymore, paid them to do so right now. Even though the ultrasound happened December 30th. My hospital obviously didn't file the claim before January 9th, and therefore, Meritain thinks they don't have to pay it. I call them, and their customer representative tells me that because my husband's company stopped paying for insurance through them on January 9th, any claims that they received after that, EVEN FOR THINGS THAT HAPPENED BEFORE JAN 9, are not legally their problem. She has never heard of anything like this before and asks me to call Meritain.
I got a call today from a flabbergasted hospital employee who tells me that old insurance (Meritain Health, might as well name them) is refusing to pay for my ultrasound, even though they admit I was covered through the 10th. Most importantly and way more essential than anything else in this post, the ultrasound was great and my son is big and looks healthy. However, we were assured that old insurance would cover this and anything through January 10th. We were aware that the company was closing and we had new insurance lined up starting January 1st, through my company. I had my 20 week anatomy scan (routine for all pregnancies) on December 30th. We were all covered on the health insurance until January 10th. Some backstory: the company my husband worked for went out of business in mid January.
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