Receiving the news that your health insurance provider is discontinuing your coverage can be, put it mildly, shocking. It may be even more unexpected if the news is delivered in the middle of your insurance term. Every year, thousands of people receive similar letters, sometimes as a result of modifications to federal or state regulations.
However, insurers are not permitted to revoke your coverage at any time for any reason. You are protected from arbitrary cancellations by laws. Learn more about the procedures you should follow if your health insurance is cancelled.
How long until your health insurance provider can cancel your coverage
Your health insurance provider cannot abruptly end your coverage. Check out how insurance cancellation laws function in more detail below.
Cancellations on anniversaries
Individual health insurance policies typically have a 12-month term with the option of a guaranteed auto-renewal. If your policy has cancellation clauses, your insurer may revoke your coverage on your anniversary date if the necessary notice is given. States may have different cancellation notice requirements, but generally speaking, they last between 60 and 90 days.
Midterm Term Absences
Midterm cancellations may also occur in addition to anniversary cancellations under specific conditions. In some situations, your coverage may be terminated prior to the renewal or expiration date of your policy. A midterm cancellation letter could be sent to you if you:
It will be discovered if you knowingly provided fraudulent or erroneous information on your application.
Pay your premiums once the allotted grace time has passed.
An insurer must give you written notice at least 30 days before you lose coverage if it decides to terminate your coverage midseason.
Your Rights Upon Cancellation of Your Policy
Your insurer is required by law to provide you with a reasonable amount of advance notice if it decides to terminate your health insurance coverage. Additionally, you have a right to be informed of the grounds for the cancellation of the coverage as well as your options for appealing the choice. You also have the right to new, need-based health insurance coverage.
You have the right to challenge the insurer's decision to revoke your coverage if you disagree with it or believe it to be unlawful.
Appealing a Decision
There are two ways you can challenge an insurer's decision to revoke your health insurance coverage.
Internal appeal: Speak with your insurance provider and ask them to perform a thorough and impartial review of their decision to terminate your policy. The organisation is required to expedite the procedure for you if you are in a pressing scenario that calls for a quick review.
External review: In certain circumstances, you may request an external review by an impartial third party. You must submit the request for external review within four months of the day you received the written notice of cancellation in order to be considered.
Depending on the medical urgency of the request, standard external reviews can take up to 45 days to complete, while expedited evaluations are completed in just 72 hours.
Your case must include being rejected for one of the following grounds in order to qualify for external review:
You or your doctor dispute with the insurance provider's medical condition assessment.
Your health care plan determines a treatment's status as experimental or investigational.
The insurer asserts that when you applied for coverage, you provided inaccurate or incomplete information.
Options for Health Insurance Following Cancellation
You can go without coverage if you can't or don't want to appeal the cancellation of your health insurance. You might look about for the new plan that best meets your requirements, which might be offered by:
The provider of your current health insurance
A business located in the marketplace
A business not in the Marketplace
You have Medicare
The TRICARE VA