[WSBAPT] Health Insurance Issue at death under Washington State Health Care Authority - Public Employees Benefits Board

[Eric Nelsen]

I have a probate where decedent, who had been a Washington state employee, died from an accident in July. In August the Washington State Healthcare Authority Public Employees Benefits Board mailed an invoice to "Estate of" the decedent, at the decedent's residential address.

The invoice is specifically for the decedent's health insurance premium for the month of death: July. If the invoice is not paid by the due date, it "may result in termination of coverage" and "any claims incurred after the termination date would be the responsibility of the estate."

The explanation in the letter is that "the Department of Retirement Systems does not send payment to the Health Care Authority for the last month of coverage or DRS recovers the premium paid for the last month of coverage from HCA." So, DRS doesn't pay for the last month of health coverage, regardless of the reason for termination, and if they already paid it to HCA, they yank it back.

So in the month that you die as a covered beneficiary, your health insurance for the month of your death is retroactively revoked unless somebody is checking your mail, paying attention to your estate, and decides to pay the premium by the due date even if a probate has not been properly opened and they have to use their own money.

Fortunately not a problem in my case, since the PR was able to advance the funds. But I can imagine this bureaucratic nightmare metastasizing into a major problem where a decedent racks up a lot of medical bills in the weeks before death, dies on say the 25th of the month, and then no one catches this little problem and the health insurance gets retroactively terminated for the 25 days of that month.

I would love it if someone would tell me that I am interpreting this wrong, and am simply being paranoid.

Sincerely,

Eric

Eric C. Nelsen
SAYRE LAW OFFICES, PLLC
1417 31st Ave South
Seattle WA  98144-3909
phone 206-625-0092
fax 206-625-9040

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