The subject of health insurance can be a sensitive topic for a lot of people. For many, it is too expensive, does not cover what they need, or it is too difficult to get approval from the companies that provide coverage in their area.

If you are one of the many who finds yourself constantly being denied for health insurance and you are not sure why, you are not alone. There are thousands of people just like you who are finding it next to impossible to obtain decent insurance at a reasonable cost.

But it is important to know just what is making you so uninsurable to these insurance companies. It may be possible to fix what you are doing wrong if you understand it or it may make it less frustrating once you know the reason why you keep getting rejected.

Here are 10 possible reasons you may be getting denied for health insurance coverage when you apply.

10 Common Reasons for Health Insurance Coverage Denials

  1. Income – Some insurances, like governmental plans, set up a sliding scale of rates based on your annual income. If your income falls above or below those predetermined numbers, your application will be kicked out by the computer before it even sees a pair of human eyes.
  2. Access to other insurance – If you are applying for independent coverage but your place of employment offers insurance, you are probably going to be denied. It doesn’t matter that your workplace’s coverage is triple the rate – just having the opportunity to have it and not taking advantage of it is enough to deny you through many insurance companies.

The same reasoning applies to those who are trying to obtain insurance coverage for their children. Family coverage through a job can be triple the cost of individual coverage and not financially affordable, but just the fact that you have access to that coverage can make your child ineligible for many other, less expensive insurances.

  1. Your career puts you at risk – If you have a career that is considered “risky” according to the preset criteria the insurance company uses to determine eligibility, you will probably automatically get denied. Common “risky” jobs include pilots and flight attendants, those in the fishing industry, roofers, and even garbage collectors.
  2. Tax return penalties – Government insurances often use tax return information to determine eligibility for coverage. If you are audited and it is found that you have falsified your return to qualify for assistance through Medicare or Medicaid, you may be banned from any government plan for the rest of your life.
  3. Risky lifestyle behaviors – Insurance companies use a rating scale to determine eligibility. Certain factors give you positive ratings on their scale and others weigh those ratings down heavily.

Engaging in risky lifestyle behaviors such as the use of tobacco, drinking, and drug abuse can throw your ratings way down and cause you to be denied for health insurance. These are not considered pre-existing conditions so it is still legal for companies to deny coverage to those who participate in these behaviors.

Even if you are approved for coverage, these risky behaviors may cause your premiums to be so high that they may not be financially feasible. You will probably be subjected to less favorable coverage with higher deductibles and copayments along with that super high monthly premium.

  1. Loss of insurance coverage from a prior job – When you are laid off from work, you are entitled to COBRA coverage to continue your health benefits for a period of time. But if you are fired from or quit your job, you are not usually eligible and will be denied.

Some exceptions can be made in which you can still benefit from COBRA coverage. In a situation where you were wrongfully terminated, for example, you may still qualify, but you will have to prove in a court of law that the termination was, indeed, wrongful.

  1. Prior bad debt with insurance – A history of non-payment of premiums from another health insurance plan in your past can block you from being approved in the future, even if you are applying with a totally different insurance company.

Certain companies will cast the net a little wider and research your financial history to see if there is a collection account in your past due to non-payment of your insurance premiums.

  1. Health conditions – Pre-existing conditions may limit you from being approved for coverage from some insurance plans. As we get older, though, it is understood that many common ailments are expected.

Government plans like Medicare cannot deny you coverage for any medical conditions. However, Medicare only covers 80% of your medical bills. To reduce your out-of-pocket costs with the other 20%, you can apply at GoMedigap plans for a Medigap coverage policy.

  1. Grandfathered plans – If you purchased a plan before March 2010, it may have been grandfathered in according to the Affordable Care Act. This means that if you have a new condition that has arisen between your last application and your renewal, you can be denied the right to renew your policy or your premiums can be raised.
  2. False information on the application – You never quite know what an insurance company will decide they want to verify on your application. It’s all fair game. If you falsified any information and they caught it, they can – and probably will – deny your coverage.

Mistakes happen, though, so innocent errors such as a discrepancy in your weight or hair color are not considered falsified information and won’t prohibit you from coverage.

You Are Not Alone – Denied Coverage is a Common Problem

Even with the Affordable Care Act, not everyone qualifies for or can find affordable health coverage. This is a work in progress and the rules and regulations are always being updated and adjusted.

If you are one of the many who are constantly being denied insurance coverage, don’t give up. Speak to an insurance expert for advice and guidance – you are not alone, and there is help available.

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