Potential Reasons For Health Insurance Denial

Unfortunately, there are many people who receive letters of denial from health insurance companies. There are a variety of reasons why this happens- some can be avoided, but not all. The truth is that certain individuals are higher risk and as health insurance is a risk business, they have to weigh certain factors to make the decisions that they do. Insurance is actually a gamble for both the insured and the insurer themselves because on either side- someone will lose money for the protection that is needed. Ultimately, the numbers are what wins, but there are a few things that you can do if you have been denied coverage.

Firstly, if you were denied on the basis of something that is inaccurate, you can dispute this. The way that the insurers receive the information about your health, whether you disclose it or not is through the Medical Information Bureau. This is something like the credit report for your health and contains medical records on anyone who has ever had health insurance of any sort and the conditions that they have had. You can do this once yearly at no charge. If you find errors, you can then go about filing the corrections and going from there.

If you have not yet been denied health insurance, or you have been denied by one company but wish to continue seeking coverage, it is a good idea to obtain a copy of this report so that you can either correct inaccuracies or better understand your position and your options. Further, one of the major reasons that people are denied health care coverage is due to age and smoking combined as a factor. Speak to your doctor about getting on a quit plan as soon as you can and see your doctor as often as you can afford to update your status in that- quitting will increase your chances of getting the coverage you need at a rate you can afford.

As to pre-existing conditions, do not fear that this automatically makes you uninsurable. There are some insurers that will accept patients with certain pre-existing conditions on an exclusion period, under certain conditions. An exclusion period is where the insurance company denies those claims relating to the pre-existing condition for a certain period of time. These greatly differ sometimes from state to state, so it is worth asking about. Bearing in mind that there are numerous factors involved in a denial of coverage, being able to find out exactly what that is and how it stacks up in your MIB report can help you to potentially find the coverage you need in time.


Source by Henry Fleet

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