So, You Can't Pay Your Health Insurance Because You're Sick. What Happens Next?

Doctors Say Obamacare Rule Will Stick Them With Unpaid Bills
Print Share
TOPICS: DELIVERY OF CARE, INSURANCE, HEALTH REFORM

By Roni Caryn Rabin
MAR 19, 2014
Doctors groups fear their members won’t get paid because of an unusual 90-day grace period for government-subsidized health plans and are urging physicians to check patients' insurance status before every visit.

“This puts the physician and their patients in a very difficult situation,” said Dr. Ardis Dee Hoven, president of the American Medical Association (AMA), which advised physicians Wednesday about how to minimize their risk.

“If a patient is being treated for a serious illness, that requires ongoing care,” she said. “The physician is having to assume the financial risk for this. That’s the bottom line.”


If an enrollee in a subsidized plan falls behind on their premium payments, the Affordable Care Act requires insurers to cover their medical bills for 30 days.

But for the next 60 days, insurers may “pend,” or hold off paying the claims -- and ultimately, deny them if the patient doesn't catch up on his premiums. That means doctors don’t get paid for their services. If the insurer ends up canceling the policy after 90 days, doctors can bill patients directly but may face difficulty collecting.

"The doctors get left holding the bag on pending claims," said Robert Laszewski, a former insurance executive and consultant.

The way things work now, insurers generally cancel a policy if a subscriber falls behind more than 30 days. The insurer is usually on the hook for bills incurred before that cancellation.

Did you read the article?

If she/he's in the hospital, they will provide service for 30 days after any insurance runs out. If the patient is comatose, they aren't going to throw the patient out of the hospital. Your so-called 'interest' goes beyond the reality of "ability to pay."

You need to make clear on the front-end why you have specific issues with health insurance. With all insurance, premiums must be paid regardless of being ill. Usually, insurance is recovered after any premium is paid. Any single person living alone and sick will lose any type of insurance when the premium is not paid on time. No premium paid, no insurance. That's a fact of life. It doesn't matter how sick the person is. That is standard practice by all insurance companies. They usually give a 30-day grace period. After that, the insurance is canceled.

Q. How is a conservatorship established?
A relative, friend or a public official may petition the court for the appointment of a conservator of an individual. The petition must contain facts establishing why the individual cannot manage his financial affairs and/or make decisions concerning his personal care.
Once a petition is filed with the court, a court investigator is appointed to interview the proposed conservatee. The investigator reports back to the court with an opinion on whether or not the appointment of a conservator is justified.
The petition is set for hearing and the conservatee must appear in court unless medically unable to do so. The judge determines, based on the petition, the investigator’s report, and any evidence taken during the hearing, whether or not the conservatorship is required and what types of special powers may be granted to the conservator.

Q. What are the advantages of a conservatorship?
While the court supervision makes a conservatorship more costly and time consuming than other methods of management, it offers a higher degree of protection to the conservatee than other management mechanisms. The conservator must file an inventory which lists all the property of the conservatee and must file accountings with the court that reflect all transactions involving the conservatee’s assets.
A conservatorship allows for the management of an incapacitated person’s affairs when he or she does not have an alternative mechanism in place to do so.
Another advantage to a conservatorship proceeding is that it provides a structured method to assist an incapacitated individual who may be reluctant to accept such assistance.

here in Ontario there are agencies who step in as conservator, sometimes even if there is family, a friend of my mother was slowly losing her cognitive abilities, her family lived about 4 hours away and had little time for her, many folks had told them to get down and get the mother help, they eventually did get to her and have her admitted for evaluation, she was admitted to the hospital and deemed not fit to care for herself, her family had papers drawn up giving them power of attorney, but the mother was in no fit state to give consent, so the conservators took over

https://www.caregiver.org/protective-proceedings-guardianships-and-conservatorships

There is more info at the link, but I think this is what you want.

Quote:

Q. How is a conservatorship established?
A relative, friend or a public official may petition the court for the appointment of a conservator of an individual....

I'll let you continue the treasure hunt from here. Good luck with the adventure.

That still presupposes family who can ultimately be prevailed upon to do it. Someone with no siblings, no children, and only a few distant cousins who couldn't care less wouldn't have even that option.