Question

3. What can make a person uninsurable in the private health insurance market?

Answer 1

Until health care reform passed (Obamacare), and the provisions are not totally in effect yet, virtually anything the insurance company can come up with. Realize that in paying claims, that is taking money from their profits, so it is to there advantage to deny claims.

They use the rubric of pre-existing conditions, and for some having been pregnant or even being pregnant is a pre-existing condition. Having been raped before is a pre-existing condition. Having been the victim of an assault can be a pre-existing condition. Almost no end to how they tie in something that may have happened to a person in the past as being a disqualifier for coverage. This normally exists when one has to get an individual policy. Through an employer, normally you have no exemptions, although there may be a waiting period for coverage for a prior medical condition. But a bonafide condition that had active treatment.

They also consider any improper answers on the application form a reason for denying coverage. So if you check that you don't have any breathing problems, and they find out when you were a kid you took some medication due to congestion, some might consider that a false answer and cancel coverage.