Reasons to Be Denied Health Insurance

If you are one of the 44 million uninsured Americans, you may consider searching for private insurance to help fund your medical expenses in the event that you fall ill. Unlike health insurance provided by employers, private health insurance companies can turn you down if you don't meet specific eligibility requirements. Eligibility requirements vary depending on the health insurance company you apply with.

Pre-existing Medical Conditions

• From a business standpoint, it doesn't make financial sense for a health insurance company to provide coverage for individuals who are likely to cost the company large sums of money. Some pre-existing conditions will result in an automatic denial of insurance. Examples of pre-existing conditions that can cause your application to be denied are: AIDS, pregnancy, cancer, or any other condition for which you require regular medical treatment. In some cases, you may be denied coverage because of prescription medications you took in the past.

Risky Habits

• An insurance company can deny you coverage if you participate in activities that place you at a high risk of needing medical care in the future. If you're a tobacco user or like to spend your weekends hang gliding and base jumping, don't be surprised if health insurance providers balk at granting you coverage. In the event that an insurer agrees to offer you a plan, it can refuse to provide coverage for any treatment you receive as a result of risky habits or behavior.

Employment

• Not all employers offer group health insurance benefits to their employees--making it necessary for employees to search out coverage on their own. Any health insurance company you apply with will want to know what you do for a living and what you've done for a living in the past. If your current job or a job you held recently places you in a high-risk group, you could be uninsurable for some companies. Miners and flight instructors, for example, may have difficulty finding private health insurance.

Previous Denials

• If you apply for health insurance and are denied, a record of that denial remains with you. Should you then apply for coverage with another provider, the previous denial could trigger a closer review of your application and your past--triggering a fresh denial that would not have occurred otherwise. Insurers keep close tabs on who is granted coverage and who isn't. A previous denial from another company is a red flag for any health insurer and could result in the company viewing you as a risk even if you're in perfect health.

False Answers

• When you apply for health insurance, you must fill out a questionnaire detailing your full medical history and any other aspects of your life that the health insurance company deems relevant so that it may accurately assess your risk level. Although it may be tempting to tell small falsehoods on your health insurance application in the hopes of obtaining a better rate, doing so is insurance fraud. In addition, insurance underwriters closely scrutinize applications. If an underwriter uncovers evidence that suggests an applicant may be hiding the truth, the company is likely to turn down the application.