Family Health Plan : What to Do if a Family Member Gets Denied

A family health plan is a health insurance policy that an adult obtains and then later adds other members of his or her immediate family to. Families obtain these policies for three main reasons. These reasons include the lower cost of the plan when compared to individual plans, the lower deductible, and the higher coverage cap. However, these plans can become tricky when one or more family members get denied.

Why Would a Family Member Get Denied from a Family Health Plan?

There are a number of reasons why a family member would get denied from a family health insurance plan. The family member may have a pre-existing condition, they may smoke, or otherwise have been seen as a high risk for any number of reasons. A health insurance company will not insure an individual if they feel will it cost them more than they are making. It is important for consumers to understand this, in order to understand why they, or a family member, may be denied.

How to Fix a Denial for Health Insurance:

Often when one family member is turned down for health insurance, the insurance company will deny the whole family or decide to cover every family member excluding the high risk member. The first thing that a policy holder should do is inquire with the company as to why the individual was turned down. If there was a mistake, then it may be possible to correct the error, appeal the denial, and obtain coverage. If not, it will be necessary to obtain coverage elsewhere.

What to Do if a Family Member Gets Denied from the Family Health Plan:

If a family member has been denied, it will be necessary to get them on an individual health insurance plan. Because they are seen as high risk, it may be necessary to obtain insurance through a state plan or through a company that accepts pre-existing conditions. While this policy may be more expensive than adding the individual to the family health plan, the savings that the family plan provides, will help to even out the costs.

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