This article will provide information several reasons why a person's past can affect the approval of their application for health insurance today. Those planning to apply for health insurance should educate themselves as much as possible about the current health insurance policy in their area. To learn more about health insurance denial reasons, read on.
History Of Past Health Issues
Some applicants are denied due to non-payment of premiums from a previous health insurance plan. This case is especially true if they have had a previous policy canceled due to non-payment and they are applying for a new one with the same insurer.Those in this situation should apply through a different insurance company, as they will have a better chance of getting accepted. However, their acceptance is not guaranteed.
Some insurance companies will research and find out if there are any collections accounts due to the non-payment of health insurance premiums, and may deny an applicant based on this criteria.
False Tax Information
Another reason applicants are denied for a government-sponsored health insurance plan is false information on their previous tax return. This reason may apply to people who are applying for Medicare, Medicaid, or plans from the health insurance marketplace.
In the past, some applicants falsified their tax returns, so they choose to apply for a government subsidy on a plan from the health insurance marketplace so they qualify for Medicare or Medicaid. Those who are caught doing this may face a penalty, or are banned from applying for a government plan for the rest of their life.
A Grandfathered Plan Can Deny Coverage Based On Pre-Existing Conditions
A plan purchased in America before March 2010 is grandfathered in under the Affordable Care Act. That is, someone can still be denied for a renewal of this plan if they have a pre-existing condition. Any new conditions will usually result in a rise in the premiums, not a denial.
Americans have been denied renewals from grandfathered plans; if these people wanted to apply for a new plan, they could not be denied based on pre-existing conditions. However, their premiums will likely be much higher under their new insurance plan.
Previous And Present Risky Habits
Applicants with a history of medically risky behavior, such as smoking or drinking, may be denied health insurance. Smoking and drinking are not considered to be pre-existing conditions, and as such are not covered under the provision of Obamacare that prevents insurers from denying someone due to a pre-existing condition. An applicant with lung cancer as a result of smoking or cirrhosis from drinking cannot be denied based on their medical conditions, but they could be denied based on their behavior. Some health insurance advocates have made the case that people should not be denied for risky behaviors, but this is not currently the applicable law.
CORBA Coverage Can Be Denied For Termination
COBRA coverage refers to the continuation of health insurance benefits after an employee has been laid off from a job. Former employees who were fired or chose to quit are usually not eligible for COBRA. Someone applying for COBRA coverage after they have been terminated may see their application denied. However, there are exceptions. For instance, if the applicant has been wrongfully terminated, they could be able for COBRA coverage, but they will likely have to prove that the firing was wrongful in a court of law.