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Anyone else declined for Individual Health Insurance coverage due to Alopecia?
I applied for an individual health insurance plan due to COBRA coverage running out, and Aetna has declined me due to alopecia (specifically that the condition and treatment exceeds allowable limits).
I was really surprised that this was the reason for being declined and am thinking of trying to appeal. Has anyone else had this happen?
-Sam
Replies to This Discussion
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Permalink Reply by Pat Latina on
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I don't quite understand why they would declined your coverage, cause they don't cover anything for alopecia. Alopecia isn't a disease that would cause additional medical problems that they would need to cover. Maybe Aetna does cover wigs for Alopecia and this is why they don't want to insure you. I know Anthem doesn't cover anything. Sorry I couldn't be of further assistance.
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Permalink Reply by Karen Smith on
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I thought that as long as you were covered for a condition continuously that an insurance company could not turn you down. Ask an attorney.
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Permalink Reply by Gail on
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Sam, go through an agent. A good agent will let you know - through experience - which companies are sticklers for certain things and which are more lenient before you even apply. Know this: every time you apply and are denied, this goes on a national database, and you must also disclose this when you apply somewhere else. I have been covered for alopecia treatments at least partially in the past and I fully disclosed the condition with the insurance company I have now (since Feb 2010).
I'm not sure there is much to be accomplished through appealing; there are many other companies out there, and if I remember correctly from my application process, Aetna is one of the worst carriers in terms of coverage.
Good luck.
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Permalink Reply by Devin on
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I have not been declined insurance, but I have been declined certain treatments so I went through the appeal process and was approved for the treatment so it is worth your time. Good Luck!
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Permalink Reply by Tim Irvine on
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I have not had to deal with this issue since 1993 when I decided not to seek treatment anymore for Alopecia. I never run into a problem because since I have no plans to file any claims for it, I never mention it. However, in your case, I will assume you are still seeing a doctor regularly. Do appeal, and see if your state has a particular law to protect pre-existing conditions.
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Permalink Reply by Sam on
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Thanks for everyone's input! In hindsight, I probably should have gone through an agent (as Gail suggests) rather than applying on my own online. Now that I have being declined on my record, I'm thinking it's pretty hopeless. I also applied with one other insurance company that I haven't heard back from yet, so there is still a chance I may get coverage.
A few more details to add----I've had Aetna for insurance for the past year and a half for COBRA, and they have covered my treatment for alopecia (a few dermatologists office visits each year, injections twice, and topical creams). Since I was so baffled by being declined due to alopecia, I've reviewed all my claims to see how much it cost them. The only thing that seems high cost wise is that one of my doctors prescribed Protopic Ointment and Clobetasol Foam. I only had the prescriptions filled once (back in '09), but I guess they don't take that into account.
Since I've had 18 months of continuous coverage, insurance companies have to cover pre-existing conditions. I'd be happy to decline coverage for alopecia if it would enable me to get health insurance (but I don't think it works that way).
-Sam
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