If you have been turned down for health insurance coverage, you have the right to know why the insurance company made that decision. If you can’t get the insurance company to change the decision, you have the option of applying for coverage under a group policy or other private insurer policy.
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In a case where you don’t work for an employer or belong to an association offering this type of protection, you can consider applying for coverage through your state’s high-risk health plan. Don’t rule out private health insurance just because one company has rejected you; it does not mean that they all will.
Find Out Reason for Denial
While it may be tempting to walk away after being turned down for health insurance coverage and not pursue the matter, please resist this urge. You have the right to be informed in writing of the reason your application was turned down. Once you have the information in hand, make an appointment with your doctor to discuss the matter.
It is possible that the health insurance company made an error in turning down your application for coverage because its underwriters didn’t have enough or the right information. Ask your doctor to write a letter to the insurance company to clarify matters that may be unclear or to add more information about your health. The insurance company may reverse its decision and agree to cover you once it receives updated or new facts about your health.
Group coverage is an option if you have been turned down for private health insurance. Insurers agree to provide health insurance for all plan members, regardless of their family history or the current state of their health. A person who has a pre-existing condition may need to serve a waiting period before he or she will be able to get coverage for pre-existing conditions, though.
A pre-existing condition is a health matter that the employee sought medical advice or treatment for before enrolling in the group plan. Depending on the health insurance plan, the time period for determining if something is a pre-existing condition may be six or 12 months, or more. If the plan member had symptoms of a medical condition but did not seek medical advice or treatment during the time the insurance company is reaching back, the condition does not meet the definition of a pre-existing condition.
The new health insurance plan member is covered for eligible services under the plan, except for those relating to the pre-existing condition. The plan administrator can advise how long the waiting period is for plan members who have a pre-existing condition. Once the waiting period has been served, the insurance will cover services relating to the pre-existing condition.
Other than the plans offered by employers, there are group health plans available to people who belong to professional or trade associations. If you belong to one of these organizations, check to see whether health insurance coverage is the one of the benefits offered to members.
High Risk Insurance Pool
If you can’t get individual or group health insurance coverage, you can look at getting coverage through your state’s high risk insurance pool. This is a last resort option for people who have been turned down by for coverage and are unable to get it elsewhere. So, before you go this route use the free health insurance quotes tool on this page to compare all your options.
The state-run plan will provide coverage but the premiums are quite high for this type of health insurance plan. In some states, new applicants are added to a waiting list due to funding restrictions. When additional resources are available, more people can be added to the list of covered pool members.
An Internet search can provide you with more information about the high risk pool for health insurance in your state, as well as the criteria for being accepted into it. You can also find out how to apply and get an idea of how much you will need to pay.
Being turned down for health insurance isn’t necessarily the end of the matter. Before you accept that you can’t get private health insurance coverage, ask for clarification and attempt to resolve the matter by providing the company with more information. If that doesn’t work and you are still without coverage, enrolling in a group health insurance plan is a possibility. They are offered by some employers, as well as professional and trade associations.
Lastly, if the doors to other options for health insurance coverage remain closed, look to your state’s high risk pool to get coverage. This should be a last resort, though, since you will be paying significantly more for this type of insurance.
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