Question:
Denied, Husband Left Comany, Now Approved.. Who pays?

Will the employer/insurance still have to pay even though he doesn't work there anymore? I submitted for approval for my surgery through my husbands employer, and they offically denied my last month. The insurance itself approved the surgery, but the plan administrator who just so happens to be the owner of the company my husband works for denied the charges. Well, my husband quit working for them a week after that, hoping to get a job with better insurance, that would give me no trouble with surgery. Well, this morning, I got an emial from the pwner fo the company, and he changed his mind and approved me! They know Danny quit, so why the approval? Do they still have to pay even though he quit? Is it because all of this was set in motion before he quit? Any help would be appreciated.    — [Deactivated Member] (posted on October 17, 2002)

October 17, 2002
If your husband Just quit last month, I would get your COBRA benefits started so that you can still have it under that insurance. It sounds like this employer may be playing games, but if he is, you may be able to beat him at it if you do Cobra and get it that way!! Good Luck!
   — Vicki L.

October 17, 2002
Pam are you and your husband paying Cobra? How can he still have the insurance if he doesnt have the job is what I am wondering. If he has insurance because you are paying Cobra prem.s then I would assume that you are approved and covered. Give the info to your surgeons office and see what they have to say about it. GOOD LUCK!!!! CM
   — Sassy M.

October 17, 2002
Does his company have more than 20 employees? If yes, After terminating from the company, was your husband offered COBRA coverage? COBRA is merely a continuation of the exact benefits that your husband had as an active employee of the company. By law, if his employer qualifies for COBRA, it must be offered to him w/in 44 days of leaving the company. As for whether the employer/insurance company will pay, I can't say. Was the email the only thing you received? Did you receive any other approval letter? I would make sure that you are eligible for COBRA and if you are, any approvals should be given to you in writing. If you have specific benefit questions, feel free to email me at [email protected]. I handle benefits for a living, so I'm happy to help! Good luck.
   — Rosario T.

October 17, 2002
The compnay had is elegible for Cobra, and my husband went and spoke to Human Resources this morning. They said the letter was mailed to us, but it was mailed to the wrong address, so the representative for Cobra is mailing another one today, and she said as son as I get that letter back to her, our coverage will be continued as of the day he quit. :) They also told me that we don't have to opt for family coverage, we can just cover me, and its $295.00 a month :( That is a big chuck of change for us, but danny said he will find a way to get the money for me.
   — [Deactivated Member]

October 17, 2002
This is the EXACT story that happened to me!!! I was denied for WLS, then my husband left the company, the exact day he left I got an approval from AETNA. I opted to get COBRA for 3 months, just so that I could get the operation, It has been the best thing I have ever done! My surgery was 8/20/02 and I have lost 34 lbs!....GOOD LUCK!
   — willcra

October 18, 2002
hi i was laid off from my job after i got approved from my insurance i wanted the surgery so bad that i went on cobra which is the same insurance as when you were working they just call it cobra you can stay on it for 18mos but it is expensive but if you take it out just for you it wont be so bad so check into it because you are already approved and whatch the timming on it there only so much time rosemary
   — ROSEMARY A.