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Issues of Insurance Denial

Jul 26th, 2010


With regard to health insurance coverage plans there are a number of issues, which are candidates for denial. Of course, most of these conditions of denial refer to the pre-existing conditions, but they are denials of health insurance benefits just the same. You can be denied health insurance coverage for a pre-existing condition for up to eighteen months and that will make living very difficult for many individuals.

Pre-existing conditions are defined as medical issues that are persistent or chronic like asthma, rheumatoid arthritis, heart disease, and diabetes. These individuals are considered a major liability to the health insurance provider. You are considered to be a very expensive liability and this does not do the health insurance provider any good because it will cost the company more money than it is taking in.

The health insurance providers issue health insurance policies more willingly to those individuals who are healthier because this is how they make their money and remain in business. Are they there to assist you? Of course, but they must have more healthy individuals paying into the health insurance fund through the average monthly cost for health insurance to build up a resource fund.

This is the major reason why most health insurance providers have a long list of pre-existing conditions to exclude certain individuals. Some of the major pre-existing conditions that the health insurance providers try to stay away from unless there is no other alternative is:

1.    Thyroid Disease, Depression, and Diabetes
2.    Cancer, Lupus, and Obesity, and Pregnancy
3.    High Blood Pressure, and Kidney Disease

Then there are what the health insurance providers consider to be minor pre-conditions that they believe they can handle when the claim forms start to be submitted. Even though the minor pre-existing conditions can become expensive, they are less expensive than the treatment for any of the major pre-conditions. A few of the milder pre-existing conditions the health insurance providers will eventually take into consideration for health care coverage are:

1.    Acne, and Childhood asthma
2.    High Cholesterol and Controlled Diabetes

The search is never easy, and it will cause much distress on those individuals who are searching for a health insurance policy.  Depending on how many pre-existing conditions you and your family members have will also determine the level of difficulty in obtaining a health insurance policy. You will have to try to remain calm and patient knowing that eventually you will succeed.

"Vista Health Solutions" Tel (888)215-4045 Email [email protected]