My son was denied health insurance!!!!!

[Little Panda RN]

I just really need to vent. My son is a truck driver and over the last few years he has put on some weight. He knows he needs to lose the extra weight and he is trying to do so. He is 6' 4" and weights 318 pounds.

He recently was offered insurance through the company he works for and the insurance company denied coverage due to his Height/Weight. That is exactly what it says "coverage denied due to Height/Weight".

Now I am sorry but he is only 23 years old, it is not like he has been over wieght all his life. But since he is now considered obese he is not elligble for health coverage. This is a crock if you ask me:angryfire. What has our health care come too? Pretty soon insurance companies will be dropping those from their policys due to being overweight.

I am just so overwhelmed by this! What is my son to do now? He is trying to lose the weight, he is a wonderful young man, trying to make an honest living but is unable to get healthcare coverage.

I wish I had all the money in world so no one would ever have to be turned down for the healthcare that they deserve. I am so saddened to think that he may have to go the rest of his life without insurance.

What is a mother to do! Sad, Sad, day.

[Katie82, RN]

I thought you couldn't be denied insurance if you are going through a group plan? If this is not the case, then wouldn't we have even more people without health insurance?

A lot of people make the mistake of blaming the insurance company when it is actually the employer who purchased the coverage. Group policies are custom written and contracted between an employer and the insurance company. The coverages and exclusions are chosen by the employer. Many companies are offering cheaper rates to companies who want to exclude coverage to employees who smoke, drink, have pre-existing conditions, or a BMI over an agreed-upon limit, such as your son has. Some companies will opt to cover these folks if the employee pays a higher premium (does not increase the employer share.) Insurance is a very big-cost benefit for companies now, and they are always looking for ways to cut their costs on healthcare premiums. Very unwise choice on the part of your son's employer. Who wants to entrust a big rig to someone who cannot afford to go to the doctor if he gets sick? Your son will not be without healthcare coverage, he just needs to find an employer who has better coverage.

[Katie82, RN]

My husband had gastric bypass surgery through his previous company's group health insurance. It's a long story but now he still works for the same company but with no benefits (anybody familiar with the mess of General Motors?). We were searching for individual policies for our family and every company was denying him due to having the surgery. One agent told me he was so-called "blacklisted" for 5 years post surgery. It's such a shame and doesn't make sense because now he is in the best health of his life.

When I was working on my Masters, I did a research paper on insurance companies. Bypass surgery was one of the hot topics at the time. Most will not cover it, and many that do resitrict the list of providers to only the most reputable programs. The track record of long-term gastric bypass outcomes is not a good one. Many folks have long-term complications, and even more end up gaining the weight back. Ins companies have it mapped out like cancer, if you reach the five year point without regaining the weight, you are considered a sucess statistic.

[Katie82, RN]

bankrupt companies don't help much either.

i'm not sure where people expect the extra money to come from. people hate paying premiums and having limited coverage yet they expect these same companies to take on additional LOSSES? math does not work that way.

True, and the amount most of us pay for health insurance is only a small portion of the actual premium. When I worked for the State, I paid about $100. a month for good coverage (that was a 5 years ago). The state paid almost $700. of my premium. But what a lot of folks don't realize is that a couple of MRIs and a routine surgery would wipe all that out....

[nursehelper]

It is hypocritical to complain about the insurance company wanting to make profits. Insurance companies are not charities.

[jeolsz]

Why is no one stating the obvious?.. It sounds like your son does not practice a healthy lifestyle. Everyone tip toes around the issue, blaming insurance companies and employers and others, but the real issue with much of our health care costs are people who don't take care the of the only body they have ( aside from future cloning of body parts). I used to smoke, and no one had trouble stating the obvious, smoking is bad for you.. why don't you quit. But I notice when it comes to the obese and sedantary, people don't always state the obvious. If you watched The Biggest Loser last season, a man was denied health coverge because of his weight. He was able to turn that around and became healthy thru a complete lifestyle change. And now that he has insurance he probably won't use it. Healthy eating and daily exersize along with adequate rest are manditory essentials in keeping down the cost of health care. And like the previous writers, insurance companies are in the business to make money.

[justme1972]

We JUST covered a chapter on weight and nutrition.

Obesity is now considered A DISEASE.

[herring_RN, ASN, BSN]

It is hypocritical to complain about the insurance company wanting to make profits. Insurance companies are not charities.

Insurance companies are in business to make a profit.

But people need care.

Isn't there a disconnect?

There used to be for profit fire fighting companies.

[nursehelper]

Insurance companies have to protect themselves because people will always try and find ways to under pay for premium services or in this case seek optimum coverage while exercising minimum effort to stay healthy.

[MoonRising]

I totally understand what the thread writer's son is going through. My husband is considered overweight and isn't eligible for private health insurance either. My husband is a truck driver with a rather large company and we were lucky to even get the crappy health insurance that they offered.

This insurance plan has a managable deductible and we pay 20% co-insurance instead of a copay. And even though its a PPO it seems to run like an HMO being that if you see someone outside of the coverage area they change their coverage level to 65%. Again this didn't seem like a problem until I had to go to the ER because I was physically assalted when I was 5 months pregnant. While they were working on making sure my baby would survive it never crossed my mind to ask if the doctor was contracted. When in the ER you get what ever doctor happens to be there. Well, this doctor turned out to be a "non contracted" doctor and now is demanding his own rather high fee ($500)in addition to the other bills we recieved during that visit, our out of pocket expense was around $1000, the cost of the entire visit was way more.

This seems like a scam to us because because when in emergency situations does anyone really have time to check if the health care provider is contracted? I contacted my insurance company about this and posed the scenario that when I go to have my baby (I'm now 9 months pregnant) if we need to do an emergency c-section will I again have this higher patient responsiblity? I was told "yes" and that the only way to avoid paying more money would be to ensure that all the doctors are contracted with the insurance company.

Does that make sense to anyone? I think I would be more concerned about my baby's life than checking coverage. I've already ensured that I went to a covered hospital what more can I possibly do during an emergency?

[jeolsz]

We JUST covered a chapter on weight and nutrition.

Obesity is now considered A DISEASE.

So is alcoholism.. and that really doesn't get the sympathy vote!.. I think there is just so many overweight people, that it has become acceptable and sometime unapproachable. Even doctors don't address it as often as they should. Plain and simple.. if you life a healthy lifestyle, you will not be obese.

[Sabby_NC]

I do pray your son finds a way to get some health insurance and loses some weight in the process.

Tell him I shall pray very hard for him.

Please do not be sad as things always have a way of working out.

[AprilRNhere]

It's a difficult situation, but honestly...I think MORE insurance companies should deny based on weight. MANY pre-existing conditions can't be helped. I don't think these people should be denied- there's nothing they can do about it.

BUT- weight loss IS possible. It takes hard work and discipline. It's not a medical condition, it's a lifestyle..and a self chosen one at that. If INS never denied anyone..our premiums would be even higher. Why should I pay more so other people can have coverage and destroy their own bodies? I work hard to live and eat healthy.

Sorry for those that I offended.