Top 8 Worst Health Insurance Denial Cases

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Health insurance denial cases are becoming more common. Of course, Congress is working on health care reforms that will prohibit companies from denying coverage for preexisting conditions. Don’t think that health care denials are out of control? Then take a look at this list of ridiculous health insurance denial stories.

1. Baby Too Big for Coverage
The parents of 4-month old Alex Lange had a difficult time trying to convince their health care provider that a 17-lb baby did not justify coverage denial, especially because the boy was perfectly healthy. After a certain amount of backlash, the provider agreed to cover Alex and change their company policy so that weight would no longer be considered a preexisting condition.

2. $1,000 Per Month Medical Coverage
A few years ago, a woman’s 60-year-old mother was denied coverage with a well-known insurance provider because she took too much medication. The policy provider did offer the mother a ridiculously expensive $1,000 per month policy that would cover catastrophic illness or injury, but even that policy would not cover regular doctor’s visits or medications.

3. Baby Too Small for Coverage
Not long after baby Alex’s parents from the first story suffered their ups and downs in being denied coverage, the Bates family found that they too were denied coverage for their child due to weight. This time, 2-year-old Aislin Bates was deemed “too small” for her age. Her parents took steps to appeal the decision; however, the denial was not officially overturned until the couple made an appearance on NBC’s “The Today Show,” with their daughter.

4. Being Assaulted is a Preexisting Condition
Christina Turner found herself in a difficult position when she applied for coverage with a new health insurance provider only to learn that it would not insure her because of medication she took. The medication was anti-AIDS drugs prescribed by her physician to help protect her after she’d been sexually assaulted. Assuming she had a preexisting condition, the insurer denied her coverage, even after she explained her assault. She would only be able to reapply in three or four years after proving that she was AIDS-free.

5. Conditions That Don’t Really Exist
A mom and her daughter were denied coverage by a major insurance provider for reasons that had nothing to do with them. According to the mother, Valerie Scaglione, the reasons for denial listed on the letter were bronchitis and a skin ailment – neither of which any family member had. As a result of being denied, she was forced to keep her five-member family with an insurance provider with excessively high rates to self-employed workers like her and her husband.

6. Too Many Normal Ailments for Coverage
A woman in California found that she was denied new coverage after her COBRA extension expired because she didn’t meet the underwriting acceptance criteria. Apparently, having migraines (which required only over-the-counter medication), a minor thyroid issue, and oh, she was deaf, something she’d functioned fully with since childhood, were too much. To date, she remains uninsured.

7. Denied for Using MySpace & Facebook
Some teenagers were denied coverage for anorexia and bulimia because of information revealed via postings on their Myspace and Facebook profiles. The insurer claimed that the online writings shed light on the causes of the disorders, which may have been mental illness. In New Jersey (where the case had gone to court), the law only requires coverage of mental illness if it is biologically based.

8. Too Pregnant for Coverage
Who knew pregnancy could be a preexisting condition? This is what Caitriona Palmer discovered after learning that while her husband could be insured, she was too close to delivery to be considered for coverage. Turning to a hospital for support, they could only promise not to charge her more than $20,000 for delivery. She also found a midwife who agreed to $100 pre-natal visits. Lucky her.

After reading stories like these, it’s easy to understand why those seeking health care coverage can quickly be daunted by the search. But while it’s not always easy to trust providers after being denied coverage without a good reason, there are companies out there that will treat you fairly. Go Insurance Rates works with these companies to provide you with access to only the best health insurance companies.

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