i did a policy with a private insurance in june 2023, i payed on time 3 months, till august. i kept using the insurance for medicine and doctors visits and in december i had an emergency visit. never got a call to collect the months of debt i had. i got a bill jan 2024 for the emergency room, i called my insurance and they payed it. in february i went to pay month of january, and in march i called to pay 4 months for 2024. In the callo agreed to pay for 2024 and i didn’t recieve a notice about the months of 2023. they as well accepted my payments for 2024. during the month i got a call again telling me i owed 2023, for 3 months. the payment in february they had placed it for september and they used my remaining payment for the other months of 2023, but i payed 679, while my monthly is 160. so i payed 4 months but only owed october, november and december. i couldn’t pay more months so i decided to cancel my insurance in april. the last payments i made was the 679 and they told me they will put that payment for the owed months and cancel my plan from the last month it covered which would be january 2024.

well now i have received a bill for the emergency room for 12,340 and they are claiming i have to pay.

i have called and they want to claim now that my policy wasn’t active for the month of december and my payment went for an owed amount that it won’t cover services. even though they had covered my hospital bill already now they don’t want to make the payment and claiming conditions that i was never told about.

See also  Section 1557 for Self-funded plans.

my age is 24, puerto rico and this is triple-s.

submitted by /u/BeneOvum
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