The Reasons Why People Are Denied Medical Insurance

Every day hundreds of applicants are denied medical insurance. For years, insured individuals assumed it was a lack of income or the absence of a stable employer that caused many in the United States to not have medical insurance. While expenses and employment do play a role in those who are denied medical insurance there are many other issues that contribute to the problem of why millions of Americans are uninsured. There are several reasons big health insurance carriers deny millions of people and below are a few of them:

Medications From the Past - Almost any type of medication that was prescribed by a doctor can result in an individual being denied coverage in the future. Most people assume that medications for conditions that have to do with the major organs such as the heart, brain, or stomach or all reasonable reasons for denial, but even medications for simple ailments raise red flags with insurance companies. A MSN report in 2008 explained how a woman was denied medical insurance for taking a fertility drug to conceive her two sons. A past history of taking medications such as anti-depressants are also a huge reason many people are denied medical insurance.


Incurable STDs - Medical insurance company will not insure most individuals who have an STD such as herpes, HPV, or HIV. Although denial claims vary from state to state, in most states an individual with an STD is considered uninsurable.

Smoking and Drinking - Individuals who drink socially or smoke are almost instantly denied health insurance due to their increased risk of illness. Most medical insurance companies request that you disclose information about your drinking habits and association with cigarettes. Any association with alcohol, cigarettes, and drugs results in an instant denial of medical insurance.

Weight - In most cases a medical insurance company will deny someone coverage because they are overweight. In these cases the medical insurance company will simply state that the individual doesn't meet the height and weight guidelines that are required to be insured. Some medical insurance companies will evaluate the denial if the individual loses the weight. Underweight individuals are also frequently denied health insurance.

Family History - People who have family histories of cancer, diabetes, or any disease that is considered genetic have a higher rate of denials than those with a healthy family. In these cases, the individual is not evaluated based on their own health but on how healthy family members are.

Pre-existing Conditions - Most insurance companies will deny any applicant that has a pre-existing condition. A pre-existing condition could be something less serious such as allergy problems or something more serious such as diabetes. A pre-existing condition is one of the main reasons that many people are denied medical insurance.

An individual who is denied medical insurance has a few options available. One option is to appeal the denial. By appealing the denial, questioning the insurance company, and finding out how coverage could be possible, some people are able to get their denials overturned. Another option is to evaluate other health insurance companies that have guidelines that could possibly allow the person to become covered. A final option is to receive a plan from a high-risk pool. Many states have an option called a high-risk pool that allows individuals who are considered medically uninsurable to obtain coverage despite the risk.