Can health insurance companies legally deny health insurance coverage?
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Asked April 22, 2013
Health insurance is regarded as a necessity for most Americans. In fact, one of the primary purposes of the Affordable Care Act, also known as Obamacare, is to make health insurance available to all Americans. To accomplish this, the ACA makes it mandatory for health insurers to accept people who were previously considered uninsurable.
In most cases, the insurance company can only deny coverage or charge higher rates for reasons that are directly related to the risk of insuring the person. In other words, unless the insurance can show that you are a higher risk, they cannot charge you more for the same coverage that someone else is purchasing for a lower amount. This particular guideline is applicable to most types of insurance, including auto, home, and health, and life insurance.
Insurance companies have long been prohibited from discrimination. They are required by law to accept applicants regardless of their race, color, sex, religion, national origin or ancestry. In 2014, the healthcare reform will make another group eligible for health insurance: those who have pre-existing conditions. Some states go even farther, and add marital status, age, occupation, language, sexual orientation, physical or mental impairment, or the geographic location where a person lives into the list of things that you cannot be turned down for. It is also illegal to refuse coverage or charge higher premiums based on a person's credit score in a few states.
If you have been denied coverage for any reason, you have the right to be informed of the reason for denial. If the insurance company did not provide you with that information at the time of denial, contact them and request clarification. If the insurance company does not provide a reason, or the reason they provide seems unfair, you have the right to contact your state's Department of Insurance and file a complaint.
There are a lot of health insurance companies out there. If you have been denied coverage by company, try applying to a different company. You can start by getting some free insurance quotes on this website. Once you have answered a few simple questions, you will be presented with a quote for coverage and some comparative quotes from other leading insurers. When you find the company that seems to offer the best deal, you can even apply coverage right away.
Answered April 22, 2013 by Anonymous