Letter of appeal to my health insurer?

Question

I was just denied individual coverage by my health insurance company after having been a member with them for several years under my small business. We closed our business and simply needed to make the change from small business coverage to individual family coverage. I want to write a letter of appeal and was looking for some samples.

Answer 1

make use of the SE like google or yahoo to get some ideas first if you want to get the massive information,however if you do not want to spend so much time,here is a direct and good resource for your questions.http://health-insurance.onlinebestoffer....

Answer 2

Well, there is no appeal.  They flat out don't HAVE to take you, on an individual plan.  They should be giving you a reason - most likely it's a pre-existing condition, a weight issue, or your age.  

You can't appeal their decision to not insure you.  Any letter you write to them, will be throw away.  The state insurance commissioner can't make them take you.  They have no obligation to give you a private policy, just because you had them for your group policy.

Answer 3

Well, any appeal letter you send should provide evidence to contradict why they are declining you.

I'm guessing that you or someone in your family has a health condition that medical underwriting rejected?

Frankly, I'd start looking at other insurers.  You can write the appeal letter if it makes you feel better, but odds are about 99.99% that the letter would be a waste of your time.

If you don't meet the insurer's underwriting criteria, there isn't much you can do about that...unless you have medical records that show their assessment of your family's health was wrong.  (Send copies of your medical records with your letter, if that's the case.)  Though you should know that if for some reason they did change their mind and accept you (unlikely), your premiums will be higher to compensate for whatever medical issue they declined you for to begin with.

The fact that you had group insurance with them previously is irrelevant...the rules for group and individual coverage are completely different.  You don't just "make a change" from a group to an individual policy.  That's not how it works.

Your best bet is to consult with a local agent to find another individual health plan in your area that will take you.

Answer 4

mbrcatz is right. they don't have to take you... The insurance company may not sell/offer individual plans in your market/area. They may only do small group, & large group plans. Try looking for private coverage at another company. Sorry.