Denied health insurance for being too fat...

TexasRattlesnake

It's the nature of insurance companies to maintain profitability... they have departments to help them make these decisions and avoid losses which outweigh profitability.

While not wanting to discuss Obamacare, the nature of it is that if everyone paid for it then costs should go down because more people are contributing into a pot which less are taking out of. The other piece to this is obviously torte reform and lowering costs, but that's a whole other thread.

As someone mentioned, private company and they have the right to make those decisions.

Wecandothis

Bobbie Clerici said:

"Because individuals who don't take care of themselves should not expect others to pay their way.
You want to live free and get fat?
You may also live with the consequences.
Just don't make it my problem. "

Whoa - who peed in your wheaties this morning.

She's here. She's doing the right thing. From your profile you were one of those 'fatties' at one time too. I'd think you'd be more understanding.

healthycrane

It's a business. A simple actuarial model. They need to keep costs under control to keep their customers. If they accepted anyone, premiums would skyrocket and they'd likely be out of business.

myfitnessnmhoy

If you were the only two obese people in the united states, your complaint about being denied would make more sense.

It's a routine denial reason. I was unable to get private health insurance for years because of it.

With employer-based plans, it's usually easier to get in because there's a larger percentage of healthier people in the risk pool, since most employers really encourage their employees to sign up and most end up doing so. With only a small percentage being obese, the insurance company is happy to take on the increased health risks of that small percentage because they are making income off the higher percentage at lower risk. In a way, the low-risk people are subsidizing the higher-risk people in a pool like that. And that's OK, because anyone can get sick, and being already in a risk pool means the resources are there to help you get better.

But for private insurance, it's a mess. You are a risk pool of one, or one family, so there are few healthy people to "absorb" risk into larger actuarial tables, and most people who seek private insurance are higher-risk, so the insurance companies can't afford to take on a high-probability loss. There's nothing out there that keeps healthy people in the system, so there's a very high percentage of people at high risk who want insurance.

But why he would qualify and she would not.... that's a mystery. I suspect the primary accountholder was him, so they set the rates based on his health and then excluded her because they didn't want the risk for both of them, or it would have increased the premium too much, or something. I don't claim (or want) to understand what goes on in insurance underwriters' heads.

jennifer52484

Welcome to health care in the U.S.! Remind me again why people are opposed to overhauling the entire health care system...

Because individuals who don't take care of themselves should not expect others to pay their way.
You want to live free and get fat?
You may also live with the consequences.
Just don't make it my problem.

While this might be true for those who are obese and are not trying to lose weight, I think that Insurance Companies should take into account an obese person who is actively trying to lose weight. Someone who has made that decision to do right for their body and health.
Does anyone know what happens to those who are denied health insurance but are required to have it by the law?

LATeagno

Move up to Canada...I have room...we will take care of you. :flowerforyou:

^^^^^
THIS
Anybody not happy in America should move to Canada.
Great advice!

PS: When all the uninsured fatties, who were more than happy to pay several hundred dollars a month for insurance, end up going to the E.R. for their obviously unavoidable according to you heart attacks and then don't pay the bills, you're going to end up absorbing the cost anyway. Just saying.

d2footballJRC

I'm going to get flamed here but....

A. It's a private company, they can choose what they want and how they do business.
B. The thresholds they have set make sense, at the thresholds they set if you look, surgery even minor ones would be a VERY VERY risky surgery. They have to think about the off chance that you need surgery where you have a greater risk of an accident and thus a greater risk of a lawsuit.
C. Everyone wants public health care and insurance reform I'm all form, what I'm not all for is doing away with options which has a good chance of stunting growth in the research and private sector.
D. You are losing weight, so you know that you have health risks or you wouldn't be doing it. Why are you livid at a company who knows you have the same issues and risks that you already know you have.
E. If you are large for a medical reason you can apply for review, if you have legit health reasons and cause they will often time go ahead and accept even over weight limit. Ex. Thyroid, medicine weight gain, and etc.

It's nothing against you, just from a business standpoint it's just that, business. You are making a change you aren't far from it, sounds like sooner than later you could pick your insurance!

Shannota

Thanks for the fat attacks here people. I am sure the OP would agree that we are trying to take care of ourselves and do the right thing by getting insurance instead of just not paying the bills when they come and then filing bankruptcy so that everyone else can pay for our shortfall. That is what causes the health care prices to go up. And I would be willing to pay a higher premium due to my weight, but that is not an option. And yes, the insurance agent will come to your door and weigh you...and if your weight isn't close to what you disclosed, you will be denied.

bm99

Please don't use this experience to give yourself a victim mentality and an "oh poor me" attitude.

You are currently too fat for them to cover. You made yourself that way. Good news though, YOU have the power to fix this situation! Congratulations on the weight you've lost and good luck on finishing your journey.

ETA: Asking people to take responsibility for their own life choices is not a "fat attack". Own your life.

LATeagno

If you were the only two obese people in the united states, your complaint about being denied would make more sense.

It's a routine denial reason. I was unable to get private health insurance for years because of it.

With employer-based plans, it's usually easier to get in because there's a larger percentage of healthier people in the risk pool, since most employers really encourage their employees to sign up and most end up doing so. With only a small percentage being obese, the insurance company is happy to take on the increased health risks of that small percentage because they are making income off the higher percentage at lower risk. In a way, the low-risk people are subsidizing the higher-risk people in a pool like that. And that's OK, because anyone can get sick, and being already in a risk pool means the resources are there to help you get better.

But for private insurance, it's a mess. You are a risk pool of one, or one family, so there are few healthy people to "absorb" risk into larger actuarial tables, and most people who seek private insurance are higher-risk, so the insurance companies can't afford to take on a high-probability loss. There's nothing out there that keeps healthy people in the system, so there's a very high percentage of people at high risk who want insurance.

But why he would qualify and she would not.... that's a mystery. I suspect the primary accountholder was him, so they set the rates based on his health and then excluded her because they didn't want the risk for both of them, or it would have increased the premium too much, or something. I don't claim (or want) to understand what goes on in insurance underwriters' heads.

He was the primary. Definitely could be right.

bm99

I understand how you feel. I am 5'4" and currently 271 pounds...down from 292. My husband took a job that he could not pass up, but that does not have a group health insurance plan, so we went shopping too. All I can get, it seems, is discount programs...not actual insurance...until I get down to 230 pounds. I have no other conditions...no diabetes, no high blood pressure, no anything. I am even doing C25K and TurboFire!

If anyone knows of a health insurance company that will look at more than just that stupid scale, please let us know! This is simply ridiculous. Smokers with other chronic conditions can get coverage, but not me???? What the F!

I totally understand. Luckily, we do have the option of continuing insurance through his school, but it costs an arm and a leg. I can see them charging MORE for overweight people, but denying altogether when they have abcolutely no other health conditions? Absolutely insane. Not to mention, none of the plans cover anything to help us lose weight. What a back-a$$ward society we live in.

If you were to stay at your current weight, you would develope health conditions. If they insured you now they would be responsible for that later.

What's *kitten* backward is that people think it's up to someone else to help them lose weight.

LATeagno

I just want to add this for those who missed it:


The insurance company viewed my weight loss as a RISK. It was part of the reason I was DENIED. When they asked if I'd lost more than 30 lbs. in the past 12 months, I checked yes.

On my DENIAL rider, it was listed, in addition to my overall weight, as a reason for their denial.

On what planet does that make sense?!

LATeagno

I understand how you feel. I am 5'4" and currently 271 pounds...down from 292. My husband took a job that he could not pass up, but that does not have a group health insurance plan, so we went shopping too. All I can get, it seems, is discount programs...not actual insurance...until I get down to 230 pounds. I have no other conditions...no diabetes, no high blood pressure, no anything. I am even doing C25K and TurboFire!

If anyone knows of a health insurance company that will look at more than just that stupid scale, please let us know! This is simply ridiculous. Smokers with other chronic conditions can get coverage, but not me???? What the F!

I totally understand. Luckily, we do have the option of continuing insurance through his school, but it costs an arm and a leg. I can see them charging MORE for overweight people, but denying altogether when they have abcolutely no other health conditions? Absolutely insane. Not to mention, none of the plans cover anything to help us lose weight. What a back-a$$ward society we live in.

If you were to stay at your current weight, you would develope health conditions. If they insured you now they would be responsible for that later.

What's *kitten* backward is that people think it's up to someone else to help them lose weight.

I don't think it's a stretch at all. Wouldn't it be in an insurance company's best interest to help their members become healthier? I'm not saying do it for them, but um... it would be beneficial to the company.

secretlobster

I just want to add this for those who missed it:


The insurance company viewed my weight loss as a RISK. It was part of the reason I was DENIED. When they asked if I'd lost more than 30 lbs. in the past 12 months, I checked yes.

On my DENIAL rider, it was listed, in addition to my overall weight, as a reason for their denial.

On what planet does that make sense?!

I will agree with you here... They must have some real idiots looking at your paperwork who can't figure out that your weight loss was a healthful one, not because flesh eating bacteria is consuming you.

RobynC79

I just want to add this for those who missed it:


The insurance company viewed my weight loss as a RISK. It was part of the reason I was DENIED. When they asked if I'd lost more than 30 lbs. in the past 12 months, I checked yes.

On my DENIAL rider, it was listed, in addition to my overall weight, as a reason for their denial.

On what planet does that make sense?!

I strongly suspect this is another way they can assess your risk - if you've previously been fat but have recently lost weight, they will view you as more likely to become obese in future compared with someone who has always been at a certain weight. If you were now under their limit but only just lost weight to get there, they definitely want to know that - another reason to charge you more or deny you coverage.

ElizabethRoad

I just want to add this for those who missed it:


The insurance company viewed my weight loss as a RISK. It was part of the reason I was DENIED. When they asked if I'd lost more than 30 lbs. in the past 12 months, I checked yes.

On my DENIAL rider, it was listed, in addition to my overall weight, as a reason for their denial.

On what planet does that make sense?!

Rapid weight loss is often a symptom of a medical condition, like diabetes.

cunfewzed1

Thanks for the fat attacks here people. I am sure the OP would agree that we are trying to take care of ourselves and do the right thing by getting insurance instead of just not paying the bills when they come and then filing bankruptcy so that everyone else can pay for our shortfall. That is what causes the health care prices to go up. And I would be willing to pay a higher premium due to my weight, but that is not an option. And yes, the insurance agent will come to your door and weigh you...and if your weight isn't close to what you disclosed, you will be denied.

I don't see any fat attacks here. I see attacks on a private company's profits. Profit is such a bad word.

Mirroring what's already been said, I definitely don't want you (or anyone) to be in this situation. I'm damn proud of you for doing your best to change it. You have a right to be upset at their determination, but it's the right one. After all, you wouldn't be actively trying to lose the weight if you didn't feel the same way their risk-assessors do.

chelseyjoan

Oh Canadddaaaaaaaaaa :happy:

mazasmusings

"People are opposed to Obamacare because for the VAST majority of people in the US the healthcare system is great. We need to fix it for the people it doesn't work for, but not take away what works very well for the majority of people. People are not opposed to fixing what's broken. FOCUS on the ~20% or so that it doesn't work for. "

Agreed.

Kristan_Forsey

Please don't send them to Canada, I already pay way too much in tax and can't afford to pay anymore. Stay where you are!