Organ transplants require written approval from the insurance carrier before the transplant. If a change in insurance has occurred and no authorization is in place, the patient is responsible for full payment of all services provided. The authorization process is lengthy; the sooner the insurance change is identified the faster the patient can be reauthorized through the new insurance carrier.
In addition, it is recommended that you contact your transplant center before making any changes during an open enrollment period. You must also remember that if you have a break in coverage between policies, the new policy may include a waiting period which could leave you without coverage for a period of time. Remember to always continue your premiums through COBRA to guarantee this.
When planning ahead, there are some important things to consider that may change over time with your coverage. Be sure to consider changes that may result from:
Reaching the maximum limit the insurance company will pay per year or per lifetime.
Divorce or separation from a spouse can lead to cancellation of coverage on the spouse’s policy.
Changes that may impact the insurance coverage; change in job status due to health, lay-off, change in student status, or other causes.
Changes in the patient’s insurance policy that can lead to increased co-pays and/or deductibles.
Children becoming adults and no longer covered under their parent’s insurance or state-funded health plans.
Children can stay on a parent’s health insurance plan until 26 years old, and after that they usually are required to find their own health insurance coverage.
Some employers will grant extended coverage past 26 years in extenuating circumstances. Check with your employer for policy details and possible exceptions if your child is in this situation.