Blogger is denied: what's the story?

I ran across this blog post from someone who was rejected for Sponsor short-term insurance by eHealthInsurance.com, even after talking to one of eHealthInsurance.com's live representative.

The blogger was exploring how to get health insurance if s/he left a job, and has Diabetes, which does complicate matters I'm sure.

I had a couple of concerns after reading this post, so I wrote to me Q&A person over at eHealthInsurance.com, asking two questions:

-Is it true that anyone with diabetes will be unable to get individual coverage via eHealthInsurance.com?

-Is it further true that they have you apply for coverage one carrier at a time, so if you get denied by the first one all the rest will know to deny you too?

As per usual her answer is long and informative (but even she has to check on part of it.) You can get the scoop if you read on...

So here are some key points my buddy made:

1. Getting short-term insurance is meant to be quick and dirty.

Or, as it was more politely put:
"These plans are designed to be quick fixes for many people when they are between jobs or between insurance plans. They generally carry limits of 6 to 12 months, with some giving an option
to renew for another 6 or 12-month period of time. As usual, they differ state-by-state and carrier by carrier. Many of these plans have been made so simple, they are down to 5 or 6 questions for the applicant to answer. Some of the carriers who offer their plans through eHealthInsurance will
approve applications in less than 24 hours, with an electronic application being submitted through our site. As you might imagine, with this fast turnaround, and with so few questions, the carriers generally have decidedwhich medical conditions are at the highest level of risk for them, so they can determine if someone gets a Short-term policy based on whether theydo or don't have one of those conditions. Obviously, the blogger had one of those conditions that he had to answer "yes" to."

So, in case you're wondering how my Pilates instructor was able to qualify for short-term insurance, it seems likely that "Do you have a congenital twisted bowel condition" probably isn't one of those short-listed conditions they check for.

2. Denial at one carrier doesn't guarantee denial at all, but you're right...it's a tedious user interface

Well, I'm sure my buddy didn't say tedious, I was embellishing. Here's what she did say:
"Major medical health insurance plans go through underwriting by the carrier, meaning that they take your application with all of your self-disclosedmedical history and determine what they will do...approve, deny, approve with a higher rate, offer a rider for a certain condition, exclude a condition from coverage for a period of time, etc. And each company underwrites differently.

So one company may not be apt to approve someone with Type 1 Diabetes and another company may be ok with that condition, but not asthma (this is just an example) This is why it's important for people to call someone who really knows the industry in the state where they live, and can help to
guide them to the health insurance company that is more likely to accept them with their pre-existing condition than another carrier might be. The customer care reps at eHealthInsurance have an enormous amount of knowledge and experience in helping to guide people with pre-existing
conditions to the carrier/s and plans in their market which are most likely to approve them with that condition."

So, you're asking: isn't that what the blogger did by clicking over to Live Chat? Well, yes, but because s/he was going for short-term insurance, the answer was likely to be much different than had s/he been going for regular insurance.

"As for your question about serial denials: I want to check with someone in our Customer Care Center to better understand that and I'll get back to you on it."

Given the discussions we've had here of late on setting up private insurance even if you can get it through your employer, or in this blogger's case through domestic partnership, it might be worth it for the blogger to try again and see if s/he can get individual insurance that's cheaper than the girlfiend's partner insurance.

Comments

[Bob]

I am not aware of a single carrier that will issue individual coverage for a Type I diabetic. (Exception would be in the "guaranteed issue" states).

This is true for STM and for traditional major medical. Type I diabetics are one of those uninsurable conditions. There are carriers that will issue modified hospital/surgical plans which is slightly better than no coverage at all but not the optimum.

COBRA, the state high risk pool (if they reside in a state with such a pool) or a conversion policy are other options.