Avoid Being Rejected by Insurers


Avoid Being Rejected by Insurers

Do some research before you apply anywhere for health insurance to minimize the chance you'll get a rejection on your record.

Thank you for all the information you've been providing on health insurance. I have read that if you have preexisting conditions and are rejected for insurance after applying, it's virtually impossible to get insurance in the future. Can you tell me how accurate this is? Also, are there any strategies for avoiding this situation?

Getting rejected by one insurer won't make it impossible to get coverage with another company, but it can make it more difficult. Most health insurance applications ask whether you've been rejected in the past, and prospective insurers will note your answer when deciding whether to offer you coverage. The best strategy is to do some research before you apply anywhere to minimize the chance you'll get a rejection on your record and make your insurance search a lot more efficient.

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Each insurer has very different rules about who it will accept and reject. One company may reject you entirely while another may offer you a good rate. Or one insurer may offer you a policy that excludes certain conditions, while another may cover the condition but boost your premiums by 25% to 150%.

It's difficult for an individual to know in advance which company is most likely to offer the best deal. But most health insurance brokers, who deal with several insurers all the time, know from experience which ones are more likely to accept people with certain conditions. In many cases, the broker can call the company's underwriter and ask questions about its criteria before submitting an application. Go to the National Association of Health Underwriters Web site for help finding a health insurance broker in your area. Ask for one who works with individuals; some just specialize in group coverage.


If you have preexisting conditions, working with a broker can also be valuable because most brokers know how to strengthen your application -- whether it's by providing a cover letter explaining how you've managed your condition or including extra information from your doctor about how your health has improved.

The broker should also have advice on what to do if you still end up getting rejected. Thirty-three states have high-risk pools that guarantee coverage to people who have been rejected by private insurers. For more information on each state's high-risk pool, go to the National Association of State Comprehensive Health Insurance Plans Web site, and click on "states with pools."

Some states may have other options, too, such as a conversion policy after you've exhausted COBRA coverage. (COBRA is a federal law that requires most employers with 20 or more employees to let former employees continue coverage on their group policy for up to 18 months after they leave their jobs.) If a broker isn't able to help you, talk with your state insurance department about your options and consumer protections. See our insurance page for links. The Georgetown University Health Policy Institute's state-specific guides for getting and keeping health insurance are also great resources (see Healthinsuranceinfo.net).

If you are rejected by everyone and end up in the state's high-risk pool, it's worthwhile to talk with a broker in a year or two to see if you can get coverage through a private insurer. Some insurers may have changed their underwriting criteria (which happens, especially as a result of medical advances), or your condition may have improved enough to make you less of a risk.

For more information and strategies for finding health insurance on your own, see You Can Get Health Coverage.

Got a question? Ask Kim at askkim@kiplinger.com.