Denied Health Insurance – What to Do Next

Countless people in the USA are denied health insurance annually and wind up facing huge medical bills as a result of pre-existing conditions. This is because so many insurance companies refuse or charge exorbitantly significant premiums for folks that suffer from such things as higher blood pressure, asthma, cardiovascular disease, diabetes, or cancer, and the end result is that these people can face substantial financial issues. However, regardless of the problem of being in this position, there are choices out there. Many health insurance providers make it possible for individuals to appeal to their choices, and there are loads of alternatives that may be considered.

Making an appeal

If for any reason you were denied health insurance, then step one is to appeal against that decision. It’ll be required to research laws about the reason for your denial, and documents should be kept on what if the business should require documentation. If your favorite insurance provider still fails coverage following an appeal, the next step is to contact an insurance agent that specializes in health insurance. Typically, health insurance agents will understand the system extremely well and can work through it and find great coverage for almost anyone. However, it may be required that the policy you’re offered contains a clause that excludes treatment for your preexisting condition. Such a situation is frequently not the best solution, but it’s a choice to be considered for many people.

Other options to consider

Though personal health insurance is the most desired policy, there are different options to consider. Anyone that has been denied medical insurance is qualified to apply for their nation’s high-risk health insurance plan if there’s one. These programs are now available in 34 states. The downside is they don’t cover specific conditions, and you’re relying on the fact that state laws aren’t going to change later on and affect your policy.

Alternately, married individuals whose spouse has business health insurance can usually get themselves included in the same plan. A number of these employer-based insurance programs do not require health checks before registration.

The Patient Protection and Affordable Care Act

It’s now only necessary for anybody to deny health insurance to discover a temporary solution to their problems, as a result of this law change in March 2010. This new law, part of their health care reform bill, is designed to prevent health insurance providers from discriminating against anyone who sufferers from a preexisting medical condition. This act already covers kids, and from January 2014 will cover adults also.

Overview: There are several choices available to anyone dealing with pre-existing illness and has been denied medical insurance. Some advice consists of possible appeals, alternative policy, and future modifications to the law surrounding such conditions.

Health Care Reform Bill – Windfall for Retiree Insurers

The current health care reform bill comprises a largely ignored clause that’s hoped will offer lots of relief to health plan sponsors that are battling retiree healthcare costs. Called the ‘Reinsurance Program’, this provision creates a subsidy for sponsors of health plans for retirees offering coverage to anyone aged over 55 years of age.

This new program provides a similar incentive to companies that are supplied by the 2003 Medicare Modernization Act. Employer groups that are eager to keep medical insurance plans for retirees will be eligible for a substantial windfall. The Reinsurance Program delivers clear benefits to businesses and companies that are dominated by unions and lumbered with expensive health plans for retirees.

The potential savings

The suggestion is that the new program will set a temporary Reinsurance Program for companies that offer medical insurance for their retirees that are aged 55 or over but now isn’t available for Medicaid. Employers and insurance companies will be reimbursed for up to 80 percent of claims between $15,000 and $90,000 made by retirees.

Taking the case of a company group that has 700 employees and 500 retirees on its own program and spends $10 million each year on its own health insurance program, the subsidy could total up to $725,000 annually, which amounts to a decrease of 14.4percent of its retiree plan expenses.

Will it work?

It’s very likely that there will undoubtedly be a group of people in the government that will try to dilute and limit the category of providers that have the ability to make claims, as we’ve learned from the lesson of the RDS (Retiree Drug Subsidy) program. In cases like this, the drug subsidy was originally supposed to be calculated together with all prescription drug costs which were incurred by plan sponsors. But this relatively simple formula was complicated by a decision made by bureaucrats to exclude certain types of medication from this subsidy. The worry is that there may be a similar rationale in this case, with specific medical expenses being excluded, later on, to be able to align eligibility with only approved medical procedures that are within the government’s basic plans as is defined by the last reform bill.

The language contained inside the bill makes it unclear as to which party will really get the subsidy. The bill in the Senate states that: “The program will reimburse insurers or companies”, while the bill in the House only gives reference to “companies”. This vague wording leaves us with the question, will the employer be eligible for the subsidy or not? This remains to be seen, but it is hoped by many that it occurs because it will only serve to benefit both employers and retirees.