How to Handle Being Denied Health Care Coverage

Today’s tough economic climate, more people than ever are finding themselves out of work and out of luck with their employer-provided group health care plan. Many folks are choosing to go without health coverage altogether, but this is an extremely risky proposition even for the very healthy. It is essential to find other ways to get or stay covered, whether it’s through COBRA, HIPAA, or by obtaining an individual policy. If you end up shopping for insurance on your own and are denied coverage, there are steps you should take: here are some ideas.

- First of all, if you know you have a preexisting condition which may make it extremely difficult for you to obtain new coverage, consider staying on COBRA for as long as possible or use the HIPAA law to your advantage by capitalizing on its no coverage denial mandate. Both of these options are extremely costly, but in some cases it may be the only way to get the same level of care you’ve been used to. You are almost guaranteed to have most insurers deny your request for individual coverage if you have a serious, ongoing health issue, so make sure to explore all of the avenues that are available to you to help prevent any loss of care.

- If you have few problems and are denied coverage, do not accept the company’s decision without inquiring further and asking “why.” You have a right to know why you are being denied coverage, and the only way to find out is to start asking questions. It may be you have been denied because of a simple clerical error or because you made a mistake on the application. If the denial was based on a health condition you can fix, then you will know what to do to in order to minimize the chances of being denied elsewhere.

- If you have been denied coverage by one company, it does not necessarily follow that another company will also deny your request. The best way to know is to work with an independent insurance agent who can get quotes and look into coverage for you from a wide network of insurers. The criteria that caused you to be denied by one company may not be as important to another. But you’ll never know if you don’t continue to actively work on getting coverage because of discouragement.

Having to seek out health coverage on your own when you’ve been used to taking it for granted can be a daunting proposition, but it is definitely feasible and there are plenty of good independent insurance agents who are ready and willing to help you find solutions.

- Art Gib