Denied health insurance for being too fat...

bm99

By all means, go to Canada. But don't try to make the USA into Canada!

You know they don't let you have guns there?? :grumble:

rchupka87

I am self employed and my husband is a doctoral student, so we have to pay for our own insurance. We're currently on his school policy, which is costing us almost $800 a month. We wanted something that cost less, so we went shopping and applied for a plan through United Health.

My husband and I are both obese. He is 6'1 and weighs about 310, I am 5'10 and weigh 264. I'm obviously working toward losing weight (hence that i'm here, and I started off weighing 337). Neither of us have any health conditions (high blood pressure, diabetes, high cholesterol, etc.) related to obesity. We're both relatively active.

Today I got the paperwork from the policy. It was probably 200 pages long. I was extremely confused because I didn't see my name on any of the papers until I got about 25 pages in. It was mentioned on a rider: a rider than excluded me from the policy because the insurance company, who makes 700 BILLION DOLLARS in profit every freaking YEAR, decided I was too fat to cover.

What really irritated me was the little chart they included. For a 5'10 man, the cutoff for denial was 282 lbs. For a woman, it was 245.

I am sitting here in tears. I see the doctor extremely rarely. Because of my weight, which I have worked EXTREMELY HARD to control, I was denied-- while my husband was included.

What ticked me off even more was that this was clearly a FAMILY POLICY. Instead of saying "hey, do you still want this?" they hid my exclusion in the middle of the packet and made no mention of it otherwise until the very end where (and even then, it still just had my daughter and hubby as included insureds).

I am absolutely livid right now. Livid and mortified.

Where do you see UNH made 700 billion last year or even close to that amount, their revenue wasn't even 700B

Um, I think you missed the point there, buddy.

Merithyn

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 work for a health insurance company processing our state's version of the Federally mandated total coverage for the uninsurable. Per the Supreme Court's recently upheld Healthcare Bill, it is required that each state mandate coverage for those that a regular insurance company won't insure. There are any number of insurance companies that these policies go through, but you have to find out what the program is called in your state. (In Illinois, it's called Illinois Pre-existing Insurance Plan, shortened to IPXP.) Once you know that, you can find out which insurance companies offer these plans. Your state's health department should have the information on their website.

The rates can only take into account one's age and if whether the applicant is a smoker or not. Height/Weight ratio cannot be considered for eligibility or rates. There is a catch, however. You must be uninsured for at least six months, you must be a legal US citizen or resident, and you must show proof of residency in the state in which you are applying to be eligible.

I deal with this policy in Illinois every day, so if you'd like some help in figuring the process out, please feel free to PM me. I can't promise that you'll get it because there is a cap on the budget per state, but I can promise that you'll at least know how to apply.

LATeagno

"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.

When I was younger, my dad had a brain aneurysm. He was in the hospital for six weeks and nearly died. Even with insurance, my parents owed more than 100,000 dollars. They had to file bankruptcy (back then you could file on medical bills). We lost our house.

The current system works well until anyone gets struck with a catastrophic illness.

Ripcode

Can't you reapply when you are under the 245lb cutoff?

LATeagno

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 work for a health insurance company processing our state's version of the Federally mandated total coverage for the uninsurable. Per the Supreme Court's recently upheld Healthcare Bill, it is required that each state mandate coverage for those that a regular insurance company won't insure. There are any number of insurance companies that these policies go through, but you have to find out what the program is called in your state. (In Illinois, it's called Illinois Pre-existing Insurance Plan, shortened to IPXP.) Once you know that, you can find out which insurance companies offer these plans. Your state's health department should have the information on their website.

The rates can only take into account one's age and if whether the applicant is a smoker or not. Height/Weight ratio cannot be considered for eligibility or rates. There is a catch, however. You must be uninsured for at least six months, you must be a legal US citizen or resident, and you must show proof of residency in the state in which you are applying to be eligible.

I deal with this policy in Illinois every day, so if you'd like some help in figuring the process out, please feel free to PM me. I can't promise that you'll get it because there is a cap on the budget per state, but I can promise that you'll at least know how to apply.

We've been continuously insured for the past couple of years, so I suppose i'm out. Thank you, though.

sevsmom

I was denied Disability insurance coverage through the company that carries my home & auto insurance because, whilst going through a miserable divorce, I had the audacity to take antidepressants! Apparently I was too big of a risk.

As for government manipulated health care. . .the articles I'm reading lately says that Canadian politicians are trying to figure out ways to privatize health care. Seems universal care is breaking the bank. It's a great idea, but it costs tons. And, it's usually paid for the heaviest on the backs of the middle class. Anyway, moving to Canada may not be the solution.

I absolutely hate health insurance. I'd rather pay the reduced rate right off the top and save the insurance for the "big" ticket items like births, surgeries, etc. But, that ain't how the cookie crumbles. And, denying people coverage just sucks. Whether it's because of weight or depression. . . .denial means you are left to twist in the wind.

cunfewzed1

I work for a health insurance company processing our state's version of the Federally mandated total coverage for the uninsurable. Per the Supreme Court's recently upheld Healthcare Bill, it is required that each state mandate coverage for those that a regular insurance company won't insure.

This isn't mandated until it takes effect in 2014. Some states (FL, for example) aren't currently complying with this mandate yet.

futuremalestripper

Oh Canadddaaaaaaaaaa :happy:

I am from Canada. The healthcare is terrible. I am friends with health professionals and they send anyone who can afford it to the U.S. Seriously. I needed a MRI - wait time? 4 months. I needed surgery? wait time? 1 year. Don't even get me started on the fact that they screwed up the surgery and I bled out on the table - I won't harp that too much cuz that can happen anywhere. However, it does bring up an interesting point that in some provinces you have extremely low cap's on how much you can sue for the deaths of minors - because kids are worth less. Oh and how about the fact that other treatment options aren't even offered because hey it's too expensive for everyone to have it so just deny everyone altogether. Dumb.

I've experienced both and the U.S. system is far superior.

As for being denied, that sucks how they approached it. But, it is their right to do it. Insurance is a benefit, not a right and it's their choice how they apply it. Just like car insurance. A lot of companies have actually been bleeding money left and right over the last few years. I'd just take it as motivation to keep pushing forward with your goals. It's not always an easy road, but you'll get there. Also, try shopping for more companies. Somebody will likely take you.

mkbrew

Gross injustice! What I don't get is why your husband is covered when it appears he is beyond the weight restriction!

2012asv

I'm sorry That is horrible and not fair. But you are not far from their maximum "weight allowance"... and the fact that you are actively addressing the issue and getting healthy is awesome!

Keep it up, you can do it. All these obstacles are just a bump in the road to success.

Good luck!

Kristan_Forsey

Lol, not having a gun is not a big deal. Plus, there are ways to legally own firearms here. Do some research before commenting.

bcattoes

I can understand that this must be a hard pill to swallow, and honestly I don't know why insurance companies don't just charge more for people who fall into high risk categories. Especially catergories that are self inflicted, such as obesity or smoking or something along those lines.

You may not have any current diagnoses, but your weight does put you in a higher risk category for a number of diseases so I can see why an insurance company would have to take that into consideration. I know I get irritated when our company insurance rates go up and I know it's because so many of my co-workers make no attempt to be healthy.

It seems more fair to just make everyone take an annual physcial and base the rate on that. That would be more fair to those that work at maintaining their health and give an incentive to those that don't to start.

vendygirl

Insurance of any kind is a crock of &*$#. All insurance companies make you pay out the wazoo and then deny you coverage in the end. Biggest waste of money EVER. Car, health, home etc.

bm99

Lol, not having a gun is not a big deal. Plus, there are ways to legally own firearms here. Do some research before commenting.

Silly Canadian. Not having a gun is a VERY big deal.

ETA: Don't hijack the topic!

AmyParker979

Can't you reapply when you are under the 245lb cutoff?

The problem then will be the amount of weight loss in the "short" amount of time. 30 lbs in 12 months, really? o.O If I only lost 30 lbs in 12 months I might cry.

Check out short-term policies (BCBS has one) and depending on the state, you can go into the "high risk pool" which, I've found, have comperable plans and premiums. They, however, mostly want you to be uncovered for 6+ months which is their version of a pre-x waiting period.

I'm in the health insurance biz. PM me if you have questions and I'll do anything I can to find an option that will work for you.

alli_baba

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?!

You can always appeal their decision. I have a friend who has a high BMI but is in fantastic shape (he is a devoted weight lifter) and needed private insurance. He wasn't denied but was charged a higher rate than he expected due to his BMI. He appealed their decision (backed up with body fat assessments) and he won. So, there is nothing carved in stone about their decision.

Was your weight the sole reason for your denial? From what I understand, that is pretty rare (especially if you are young). Typically, if you have a history of frequent/chronic medical problems in addition to higher weight, you may be denied.

Whatever you do, though, don't lie on an application. I have heard of people doing this and winding up with a cancelled policy (and a huge bill) when they needed treatment.

Best wishes to you! It doesn't sound like you have too far to go to get under their weight threshold, so simply view this as a temporary setback.

likeschocolate

I agree, what they have done is distasteful and shows very little compassion or value for a fellow human being.

Mathematically -- the people who qualify for insurance are those for whom it is not logical to take it (if it did - the insurance companies do not make a profit from you).

Same story with the casinos--mathematically, the odds are stacked in favor of the house. Or they would not want you to play roulette at their establishment.

Of course you can't put a reasonable price on "fear" (insurance) and on "wishful thinking" (casino) -- so people play the game.

The primary goal of an insurance company (or any business) is to make profits. These are not a charitable companies nor non-profits. You could argue that fundamentally, that is not the model that provides most benefit to society when it comes to social services. But that is a debate for another day.

As you said -- you have been relatively healthy, thank God. Why give them your money when they don't want it? Again, from a mathematical perspective -- you could use the $800 a month and invest it wisely for a good 5-8% return per year (tax-free bonds ~5% per year, and higher risk stocks usually can give you more than that). The investment should exceed the cost of healthcare of you. Then you could choose to wait till you're healthier and your husband has his post-PhD job (many academic positions come with nice benefits), unless you have imminent health concerns.

Wish you all the best regardless, and hope you and your family do not have occasion to see the doctor! (wishing you good health)

bm99

Insurance of any kind is a crock of &*$#. All insurance companies make you pay out the wazoo and then deny you coverage in the end. Biggest waste of money EVER. Car, health, home etc.

Imagine putting that $800 away in savings each month, following a healthy eating plan and exercising regularly. The insurance company is betting on making money off you, why not do it yourself and keep the profits?

That's what I did when I was young and healthy. Now we have gub'mint insurance and they insure my fatass whether I want them to or not.

Sharon_C

When I was younger, my dad had a brain aneurysm. He was in the hospital for six weeks and nearly died. Even with insurance, my parents owed more than 100,000 dollars. They had to file bankruptcy (back then you could file on medical bills). We lost our house.

The current system works well until anyone gets struck with a catastrophic illness.

This is a blanket statement that is so not true in a lot of cases. I know this for a fact because my husband had a catastrophic injury that cost a quarter of a million and our insurance covered it all. So, the current system did work for us as well as a lot of other people I've encountered along the way.