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In June 2020, I had a biopsy (negative). At the time, I was “covered” by ACA-compliant insurance that was paid in full, in good standing, etc. I paid the required co-pay on the day of the procedure. The insurance company approved payment for the balance. (The word they kept using was “adjudicated”.) But they never actually paid the provider. The provider billed me for the balance.

I repeatedly called the billing office, and (when I could reach anyone) the insurance company. Each time, it seemed as though I’d resolved the issue. Each month, I got another bill, and started over. The insurance company went out of business at the end of the year. They sent out marketing material that included a phone number and a website to resolve issues. But the phone was never answered, and the website was just a landing page with a lot of links to “under construction” pages. So far I’ve refused to pay, and now it is being turned over to collection. Do I have any options here?

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    State will matter here; some have specific laws against surprise bills of this nature. Your state also likely regulates insurance companies, and should be able to intervene here. In my state, dfs.ny.gov/complaint would get the wheels going, and a call to my local state senator or representative would probably make it pretty quick.
    – ceejayoz
    Jul 14 at 17:55
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    @ceejayoz I don’t think this falls into the legal definition of “surprise bill”. However, you’re spot on in regards to contacting the state insurance regulator.
    – RonJohn
    Jul 15 at 4:10
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    Accept the real possibility that “bankrupt insurance company” means that you’re on the hook for the bill.. If so, tell them you’ll pay them what they would have billed the insurance company.
    – RonJohn
    Jul 15 at 4:13
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    @RonJohn Most states have a "guaranty fund" or "guaranty association" for health insurance that would kick in in an healthcare insurer's bankruptcy to cover bills. I would not pay the bills without talking to the state's insurance regulators first.
    – ceejayoz
    Jul 15 at 14:16

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Contact your state government. All insurance in the United States has a heavy state specific component. The state regulates which companies can do business in the state. They have offices that can resolve problems. They may even have a fund that will protect consumers in your situation.

You will have to dig though the state website, or a related website. It is also possible that if the policy was purchased though your employer they can help. If you had the insurance though the state specific insurance portal they can either help or point you in the right direction.

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