What Are My Options if I Was Turned Down for Health Insurance?

If you have been turned down for an individual health insurance policy, it is most likely because of a pre-existing health condition. Many insurers will not cover any pre-existing conditions in which you received treatment within six months of applying for insurance. However, that doesn't mean you are without options. Private insurers may extend coverage with stipulations. In addition, the Affordable Health Care Act requires coverage for individuals who cannot obtain insurance due to pre-existing condition.

Pre-Existing Condition Insurance Plan, PCIP

• The Affordable Care Act, passed and effective as of September 2010, is a federal act that has a provision for the Pre-Existing Condition Insurance Plan. The PCIP mandates coverage for those who have been denied or cannot afford private insurance because of pre-existing conditions. Many states have a PCIP but for those that don't, a federal program is available. The PCIP guarantees full comprehensive health insurance coverage if you qualify for the program.

PCIP Eligibility

• Per the PCIP, you must meet certain qualifications to obtain coverage. To be eligible, you must be a United States citizen or be a legal resident in the U.S. You also must have not had any insurance coverage for at least the past six months. Most importantly, you must have a pre-existing condition and have been turned down because of this health condition. State-run PCIPs may have additional eligibility requirements or varying definitions for what qualifies as being turned down for pre-existing conditions.

Individual Insurance Options

• Although one health insurance carrier has turned you down, you should still apply to other carriers. Some insurers allow more flexibility in their underwriting criteria and may allow you to enroll, although the policy cost may be high. Insurers may also offer you coverage, but exclude the pre-existing condition or allow you to buy a rider that specifically covers the condition causing the original application denial. Visit the websites of several carriers and apply online or by calling representatives to inquire if they will extend coverage to you.

Bottom Line

• You can still find health insurance coverage, even if insurers consider you high risk. Though you may pay higher rates and be subject to benefit waiting periods, where pre-existing conditions are covered after a long period, you may still find individual insurance. Complete your search by applying to multiple carriers and asking about riders and exclusions. Most likely, you will qualify for the PCIP. You can find out more information about the PCIP by visiting healthcare.gov or your state's insurance department's website.