Reasons You Can Be Denied Health Insurance

The recent passage of the Affordable Care Act, also known as Obamacare, has ensured that Americans cannot be denied health insurance for pre-existing conditions. However, there are still many reasons that people can be denied health insurance coverage. There is even an exception to the rule that Americans cannot be denied for pre-existing conditions. This article will provide information several reasons that an application for health insurance may be denied. Those planning to apply for health insurance would be smart to educate themselves as much as possible about the current health insurance situation. To learn more about health insurance denials, read on.

Annual Income May Be Above Allowed Levels

Those applying for certain government-administered health insurance plans like Medicare or Medicaid can be rejected if their income is above a certain level. How much income Americans can have and still qualify for these plans depends on some different factors. There is a sliding scale that increases or decreases depending on how many children are in the family. For example, a family that has three children can earn more money and still qualify for medical care, over a family with one child. The base numbers on the scale change year to year, so families are advised to check this information on a regular basis.

Eligibility For Coverage Through A Spouse

Those that are trying to obtain a subsidized health insurance plan through the government-sponsored health insurance marketplace may be ineligible if their spouse has a plan that can cover them. This does not mean that these applicants cannot get any of the plans listed on the health insurance exchange, it simply means that they are not eligible for government subsidy. Thus, they can be rejected if they apply through the health insurance marketplace for such plans. If those individuals go outside of the marketplace, they will not be rejected due to their spouse’s plan. Of course, plans purchased outside of the marketplace will be much more expensive.

Children Accepted On Parent's Insurance

Certain states sponsor a health insurance program for children born into low income families. The eligibility criteria for these plans differs from state-to-state as not every state has similar plans for children. People wondering whether or not their state has a government-sponsored plan for children should check the state health department website. Many of these plans will not cover a dependant if they are eligible for coverage under their parent’s plan. Some states will still allow a dependant to be coverage through the government plan, even if the parent has a plan that can cover them. In this case, the family must earn less than a certain dollar amount per year.

Risky Job Or Career

Working in a risky or hazardous career field is one little-known reason certain individuals are denied health insurance. The number of occupations that are considered hazardous enough by an insurer to deny an applicant outright are fairly small, so many do not know about this practice. Firefighters and police officers may be denied appropriate coverage if they try to get another plan, other than the one offered with their position. Most in this situation are offered a fair plan through their job, and so are fortunately not greatly inconvenienced.

Incorrect Information On Application

Insurers are allowed to deny an application based on incorrect information. An insurer will usually do a background check as well as look into medical records to ensure that the applicant isn’t falsifying information on their application. Insurers in most states are legally allowed to deny an applicant solely based on any incorrect information found on their forms. However, in California, insurers are only allowed to deny someone based on wrong information that could affect medical care. For example, if someone with hazel eyes puts their eye color down as green, the insurer cannot deny their application on this basis.