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Report: Millions Denied Insurance Coverage For Pre-Existing Medical Conditions

Posted by Chrissie Cole
Wednesday, August 12, 2009 10:48 AM EST
Category: Major Medical
Tags: Protecting Your Family, Health Care Reform, Health Insurance Reform, Coverage Denied, Pre-Existing Medical Condition

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IMAGE SOURCE: © HealthReform.gov

The U.S. Department of Health and Human Services (HHS) has issued a new report on insurance coverage denials. The report examines the insurance company practice of denying coverage and discriminating against millions of Americans who have pre-existing medical conditions.

The report, called “Coverage Denied: How the Current Health Insurance System Leaves Millions Behind,” uses previously published data from American Heart Association, Commonwealth Fund and Kaiser Family Foundation, among other sources, to highlight insurance industry practices.

12.6 million Non-elderly adults – 36 percent of those who tried to obtain insurance directly from companies in the individual insurance market – were denied coverage during the last three years, charged higher premiums or refused coverage for a pre-existing condition, according to a recent national survey.

Another survey found 1 in 10 people with cancer could not get health coverage, and 6 percent lost coverage due to their diagnosis.

The practice of denying coverage based on pre-existing conditions – a medical condition that existed before some applies or enrolls in a new health insurance policy – is not confined to only serious diseases; it can also include relatively minor conditions such as asthma or a previous sports injury.

Moreover, when patients are diagnosed with expensive conditions, (i.e. cancer or heart disease) come companies respond by reviewing the patient’s initial health insurance application. In most states individual insurance market insurers can retroactively revoke the policy for any undisclosed condition, no matter how minor, even if the person was unaware of the illness at that time. Coverage can also be rescinded for the patient’s family members, if they failed to disclose a medical condition. This practice is referred to as rescission.

Health Insurance Reform

Insurance companies would be barred from refusing coverage based on medical history or health risk under health insurance reform. The companies would also be prohibited from dropping or watering down insurance coverage for those who are or become sick. #


5 Comments

Anonymous User
Posted by Byrd
Wednesday, August 12, 2009 5:14 PM EST

Is the part of the proposals that O'bama is trying to get started? Or is it something else that might happen soon?

Anonymous User
Posted by seth
Friday, August 14, 2009 4:29 PM EST

If this requirement is removed, than people will only buy insurance when they get sick...resulting in higher premiums for those of us who continually maintain health insurance.

Posted by Ben Glass
Friday, August 14, 2009 4:54 PM EST

The Wall Street Journal actually has an interesting proposal on this issue. The big problem is that when people lose jobs their insurance often terminates...certainly requiring insurance companies to insure, even though there are preexisting conditions, makes no economic sense. But, permitting an insured who is leaving a job to buy some sort of "tail" coverage is one solution to the problem.

But Seth is right, insurance is a business and forcing an insurance company to accept people it doesn't want to accept at a price it doesn't want to accept is a dangerous path to go down.

Anonymous User
Posted by Byrd
Friday, August 14, 2009 8:40 PM EST

The "tail" insurance has to be affordable....don't forget that the breadwinner just got laid off and has no income except unemployment benefits...I'm not so sure that insurance companies are "required" to insure but I don't know everything about this....we had the option of COBRA...at a price...some look at it this way...if I can afford to pay $300.00 plus a month for COBRA then I can afford to pay the bills...it does not work this way I don't guess...but I recognize what you say...I don't want my premiums to go up either because of another case...thanks for posting and keep the thoughts coming...we will get through this together...

Anonymous User
Posted by Allen
Thursday, August 27, 2009 11:43 AM EST

Sorry I just want folks to know that no matter if you are for perposed change or not this is one thing that should be fixed.

Even if you are protect by your job where you have group insurance don't think this will never affect you. God help you if you lose your job at the wrong time and you show a risk to the insurance companies. By the way the older you get the worse or more likly hood this will crop up.

That said, this really affects folks like myself who are self empoyeed.

I was diagnosed with a heart problem 15 years ago. I develop an ireguarl heart beat once in a while. This is not something that happens all the time, 5 times over 6 years where it would last for 24 hours or less. The rest of the time I have a normal heart beat.

By taking care of myself I have had no problems over the last eight years. However it is enought that the insruance companies think I might be a risk.

Again I have to buy my own insruance as I am self empolyeed, small mom and pop. The insruance company has driven my rate up 200 precent over the last seven years to a point I can no longer afford it. For just me it is over $1300 a month my wife pays $390 and she is five years older. This is more than I pay for my own home.

In other words they have driven me out of the system. For over five years I have been looking for other options but no other insruance company will take me. Yes I have looked at them all. Before you say it group insruance for the business is $1500 for both of us. Not enough of a saving and not near the coverage.

I am forced now to go to a plan with only the min in coverage. Basicly if you get sick you die. Sorry not really but it is truly the way you feel.

The one thing I saw here that got me worked up. It is more than a business it is my life. By saying so you are telling me my life is worth less than yours. In this country health insurance should not be just for the young or the rich. Everyone should be able to find afordable health care.

Thanks for letting me vent. As I said, this very thing can affect anyone and to think it won't is a real mistake. Please think how you would feel in my place.

Comments for this article are closed.

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