Acne, allergy, and toe nail fungus make you uninsurable

Source: The Long-Term Care Company

One reason we need health care reform is the insurance industry practice of canceling or refusing insurance coverage. Since insurance companies are profit-making endeavors, it’s understandable that they don’t want to insure someone with a history of cancer, diabetes, or even arthritis.
What about those people who truly believe they’ve always been healthy? When it comes to insurance, health is in the eyes of the beholder — in this case the eye’s of the insurance underwriter.

Insurance underwriting is the art of determining how much coverage an individual should receive, what it should cost, and whether an individual is an acceptable risk. The underwriter’s goal is to keep the insurance company profitable.
The advocacy group Consumer Watchdog was able to obtain the underwriting guidelines of major insurance companies (Blue Cross, Blue Shield, PacifiCare, Health Net) from a California insurance broker. They’re now available online (see Sources below).

Expectant father? Automatic grounds for rejection

Here are some of the reasons you can be denied insurance.
Uninsurable occupations include:
– Athletes
– Firefighters
– Police officers
– War correspondents
– Air traffic controllers
– Construction workers
– Public utility workers
– Migrant workers
– Test pilot
– Circus worker
– Stunt person
You are uninsurable if you take any of the following prescription medications:
– Lamisil (for toe nail fungus)
– Allegra (allergies)
– Zyrtec (allergies)
– Advair (asthma)
– Lipitor (cholesterol)
– Nexium (heartburn)
– Imitrex (migraines)
– Prevacid (ulcers)
– Celebrex (arthritis)
If you have one of these conditions, you are considered uninsurable:
– Acne
– Hemorrhoids
– Bunions
– Asthma
– Chronic tonsillitis
– Varicose veins (and candidate for surgery)
– Arthritis
– Attention deficit disorder
– Pregnant
– Intention to adopt
– Expectant father
– Therapy/counseling
One document stated that being an expectant father was grounds for “automatic rejection.” Likewise, having received therapy or counseling within the previous six months was a no-no.
If you still think you might be eligible for insurance, there’s a general catch-all that can be used to disqualify you: “Currently experiencing/experienced within the last 12 months symptoms for which a physician has not been consulted.” That includes just about everyone.

Without the public option, the insurance industry will continue to game the system

The documents that health insurance companies provide to underwriters are very interesting. The PDF versions below (under Sources) are not too long and not difficult to understand. I recommend taking a look. They really bring home that the insurance industry is a for-profit business that’s not about to insure anyone who might have a medical expense. No wonder so many people are without private insurance.
According to Consumer Watchdog’s Washington D.C. Director, Carmen Balber:

These documents show why health care reform must include serious curbs on insurance companies including regulation of rates and practices so insurers can’t continue to price gouge or find new ways to refuse customers as part of their business model.

Consumer Watchdog’s Health Policy Director, Jerry Flanagan, made this statement:

These documents show that just giving the insurance industry an uncontested franchise by requiring Americans to buy policies will not solve the health care crisis. Americans need a strong ‘public option’ which would not have the tendency to game the system like private insurers.

There’s one way you can sometimes get insurance from these providers even if you do have toe nail fungus or a bunion. You can pay an exorbitant cost. That’s the other reason so many Americans lack adequate insurance.
Related posts:
Why we passed health care: WellPoint and breast cancer
Without the public option, it’s not health care reform
Congress finds health insurance industry fundamentally flawed
Why health insurance isn’t there when you need it most
A health insurance executive changes sides