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Recently in Health Insurance Eligibility Category

Question: I just recently found out my individual insurance with Anthem Blue Cross was canceled due to a book-keeping error on my part. I filed a grievance with them stating I would pay all fees and penalties. In the meantime, they told me to apply again for another plan. Being truthful, I told them that I was in the middle of having a physical and blood work. They denied this new policy and states they need to see the results of the blood work. I literally just received the blood work back today and it says I have high cholesterol (My BMI is 24.3)…I haven’t even had a chance to speak to the doctor about it yet. I’m now terrified to send the insurance company this result for fear of being denied coverage. I’m unsure what to do, this is the first time I’ve ever been without health insurance my entire life.

Answer: Based on what you’ve told me, I recommend that you comply with Anthem’s request for the records and finish that application. Your high cholesterol is not a “knock out factor” by itself. Your height and weight are within the guidelines, so you could be approved for coverage, but will probably be looking at a 25% to 50% rate increase for the cholesterol. If you don’t get what you want from Anthem, call my office at 800-557-5693 and we will try to find coverage for you.

Question: My employer offers me health insurance for me and my family, however the cost deducted from my pay check is outrageously high, were talking about $500 a pay check. I can’t afford that payment, and on top of that, the coverage is horrible. It would be far cheaper for me to purchase an insurance policy myself though a company outside of work, at half the cost, and with far better coverage. However all insurance companies I’ve called have denied coverage because my employer offers me insurance. Is this a law that Insurance companies can’t offer insurance for individuals who are given the option through their work?

Answer: You cannot be denied individual health insurance because you have group health insurance available. I don’t know why you were told otherwise. Perhaps, you are being denied individual health insurance because you do not meet the underwriting requirements - most frequently for preexisting medical conditions.

QUESTION: My husband's job does not provide health insurance. We had regular insurance for him until COBRA ran out. He went to a limited benefit health plan but the plan has gone under. Is there a plan, any plan, that would cover my husband? Indiana does have a high risk insurance pool - We'd have to pay about $800.00 per month for it - we can't afford it.

Cheaper Health Insurance

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Question: Hi, first thank you for this great q&A. second, i last applied for health insurance about 5 years ago and i am currently still overweight. (5'7" 258lbs). bp is undercontrol as is cholesterol with the use of caduet 10/10. no diabetes, hx of asthma as a child, recent xray showed a small rough area of the socket in my hip, not really an issue according to my chiropractor. i need some relief from the premiums i'm paying currently, any chance of some cheaper insurance?

thanks again for the help

Question: My mom is currently insured under COBRA/CAL-COBRA (which expires Oct. 1, 2008). She applied for the Kaiser Permanente Individuals and Families" health care coverage and was denied coverage. The reasons being: she has High Cholesterol, was diagnosed with tendonitis of the shoulder and bursitis of the hip (she gets steroid injections to relieve the pain) and was diagnosed with bilateral carpal tunnel syndrome with surgery performed on the left hand in April 2007. Can you please suggest an affordable health insurance plan that will not deny her? She is 64 and will be 65 in 2009.

Insurable?

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Question: My parents keep telling me that they are uninsurable because my mom has diabetes and my dad has high blood pressure. They are 58 and 62 and would like to retire, but need health coverage. Other they would both like to lose a few pounds, I don't think either would be considered overweight.

denied health insurance

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Question: Three years ago I was denied BCBS coverage. Can I ever get coverage again?

Question: My husband and I are self-employed and need to purchase insurance. We applied to Unicare and while he was accepted, I was denied due to my "build" (their term). I have no history of high blood pressure or any other health issues often assumed to be linked to a bigger "build." In fact, I lead a healthy lifestyle, walking several miles everyday.

What is my best next step? Shall I apply to another company and simply fudge my height/weight? 10lbs less or 1/2 inch taller and I am within "desired" BMI levels.

Question: I take Lomectol for bi-polar. I was denied coverage by blue cross blue shield nevada. Dont you think thats insulting? I thought it was mean.

Question: I never see a doctor but consider myself fairly healthy. My wife on the other hand takes really good care of herself and sees her doctor for regular maintenance. Over the past year she has had trouble getting her thyroid levels right, which gave her a bit of high blood pressure but her doctor says their ok now and the blood pressure also. She is 5 ft 3 in tall and weighs 172 pounds. She was declined by Blue Cross 18 months ago and now we want to try and add her on to my plan because she's not covered at all right now. We live in Shasta County, CA which means we can only to apply Blue Cross or Blue Shield. I guess no other companies operate out here.

Question: My wife is completely healthy and takes premarin for menopause. I have high blood pressure and take a low dose of Mavik to keep this controlled. I've been told by Aetna that they charge an extra 25% on top of the standard premium for this. This doesn't seem fair with my wife being so healthy -- why is she being penalized? She goes to curves and stays fit, eats well and takes good care of her self.

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