|  | Healthcare Industry | Health Insurance

What to Do if a Health Insurance Application Is Denied?

It can be a shock to find out your health insurance application has been denied. After spending hours filling out a 15-page to 20-page application, turning it in and waiting weeks to find out if it was approved, the letdown from a denial is big. You do have some options, however, after your application is denied.

  1. Application Copy

    • Keep a copy of the first application you submitted. The questions on most health insurance applications are very similar. You can save yourself a lot of hassle trying to remember the last time you went to the doctor for a certain problem or what prescriptions you have had in the past two years when you fill out other health insurance applications.

    Try Again

    • Each health insurance company is different. What one considers to be a "pre-existing condition" may not be a big deal to another company. You may be accepted by another company, but your rates may be increased due to your condition. Turn in three or four applications to be as certain as possible that health insurance companies in your area will not accept you.

    Medical Risk Pool

    • If you have a condition that your health insurance broker is reasonably sure will be denied no matter what company you apply with, or if you have repeatedly been turned down by other companies, check with your state's department of insurance to see if your state has a medical plan for people who cannot get health insurance elsewhere.

    Example

    • Colorado, for example, has a medical risk pool called CoverColorado. For people who have been denied health insurance by at least one company and who meet other eligibility requirements (such as being accepted by a health insurance company, but at a rate higher than CoverColorado would offer), it offers guaranteed coverage. It also offers discounts on premiums to those under certain income limits. You may have to wait a year or so to have your pre-existing conditions covered if you cannot prove you have had coverage recently. Contact your state's medical risk pool program for specific information in your state.

    Clinics and Doctors

    • If you cannot get health insurance, you can visit public clinics that accept individuals without health insurance. They may be able to refer you to specialists who will offer their services for free or at a discount. Paying in cash often can get you a discount. You can also ask for the same price that the physician would charge to insurance; doctors often charge individuals higher than insurance companies for the same services.

    Other Tips

    • Walk-in clinics can offer you many of the same services as traditional doctors' offices for a comparable or lower price. Independent facilities offer lower prices on services such as MRIs than hospitals. Try to negotiate your pricing upfront, before you receive a medical service. Call different doctors to find out what the prices are for particular services for self-pay patients if you know the exact service you need. Look up the service on the Healthcare Blue Book website to find out what a reasonable price is for the service you need in your area. Get the pricing agreement in writing if you negotiate a discount on any service.

Health Insurance - Related Articles