Legal Question in Legal Ethics in Massachusetts
Today is 10/14/09, Today my company told it's employees that as of November 1, our health insurance is changing from a No deductible plan to a High deductible plan. Not only does this require a high deductible be met over the course of the calendar year, but it is now 2 months from the end of the year and that high deductible only counts for 2009 and restarts in 2010.
In my case, I have several Doctors appointments scheduled in the month of november, as well as a CT Scan, and physical therapy. All of which will have to now be paid for out of pocket with no warning because of the deductible. Any new treatment as of the 1st of the year will also start new to the calendar year towards the deductible, and will also have to be paid for out of pocket. I scheduled these appointments very far in advance due to the waiting time of 1-7 months do be seen depending on the appointment. The time period is out of my control, and I accounted for spending the usual co-pay to be seen, and now I am being forced to come up with the total value the DR. is charging with 2 weeks warning. Is this legal? What can I do? I have a fractured vertebra so this is not something that can just be "put off" until the next calander year, or until I can come up with the money.
1 Answer from Attorneys
Generally, plan years run from the date of start to the date of finish, not necessarily with the calendar year. First, check to see if the "Plan Year" runs from NOV 1st 2009 thru OCT 31st 2010. You may also want to look into the Commonwealth Health Insurance Connector Authority - you canstart a new health insurance plan there as soon as November 1st, and the rates for private insurance, even "Gold Standard" plans with no deductibles and low co-pays are inexpensive - certainly less than ahigh deductible would cost.
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