HMO Plan

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PostPosted: Thu Mar 06, 2014 9:44 am   Post subject: HMO Plan  

I have an HMO Plan but I am now being told that none of the charges from my entire pregnancy are covered under the insurance and that I'm not going to be paid as it wasn't pre-approved by my Primary Care Physician. The bigger problem is that they're denying the other hospital charges as well? Am I obligated to pay?

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PostPosted: Sat Mar 08, 2014 1:06 am   Post subject:   

Pregnancy is covered under all non-grandfathered individual qualified health insurance plans as of 1-1-2014. True group health insurance has been required to provide coverage for pregnancy for years. Pregnancy does not require "preapproval" of a Primary Care Physician.

If your pregnancy ended prior to 1-1-2014, then it is possible that nothing was covered. Unfortunately, you have left out some important details based on dates.


CA-licensed Life & Disability Analyst. CA Insurance Lic #0596197. Also investigating insurance company abuses, and providing litigation support/expert witness services. Send me your questions, and I'll send you my answers.
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