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Also, I believe, (and I could be wrong) that if you've applied for something

and it's been denied, if the appeal is overturned even after you're no

longer covered, they have to cover the service because you applied before

your coverage ran out.  Any insurance people out there who can verify this?

Unfortunately...No. If the policy is cancelled prior to the date of service,

then the service is not eligible for reimbursement. The predetermination

responses include disclaimers as well, one of them is that you " must be covered

on the date of service to be eligible for benefits " .

Now, this could be different if you are referring to appeals through

litigious means. If the delay is due to court sessions, then the court (if they

overturn the insurance denial) may include in their decision that it has to be

covered, but that would be up to the ALJ or whoever is presiding.

Chrissy

OpenRNY 02/19/03

310/223

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