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I applied for an individual health insurance plan due to COBRA coverage running out, and Aetna has declined me due to alopecia (specifically that the condition and treatment exceeds allowable limits).
I was really surprised that this was the reason for being declined and am thinking of trying to appeal. Has anyone else had this happen?
I don't quite understand why they would declined your coverage, cause they don't cover anything for alopecia. Alopecia isn't a disease that would cause additional medical problems that they would need to cover. Maybe Aetna does cover wigs for Alopecia and this is why they don't want to insure you. I know Anthem doesn't cover anything. Sorry I couldn't be of further assistance.
Sam, go through an agent. A good agent will let you know - through experience - which companies are sticklers for certain things and which are more lenient before you even apply. Know this: every time you apply and are denied, this goes on a national database, and you must also disclose this when you apply somewhere else. I have been covered for alopecia treatments at least partially in the past and I fully disclosed the condition with the insurance company I have now (since Feb 2010).
I'm not sure there is much to be accomplished through appealing; there are many other companies out there, and if I remember correctly from my application process, Aetna is one of the worst carriers in terms of coverage.
Thanks for everyone's input! In hindsight, I probably should have gone through an agent (as Gail suggests) rather than applying on my own online. Now that I have being declined on my record, I'm thinking it's pretty hopeless. I also applied with one other insurance company that I haven't heard back from yet, so there is still a chance I may get coverage.
A few more details to add----I've had Aetna for insurance for the past year and a half for COBRA, and they have covered my treatment for alopecia (a few dermatologists office visits each year, injections twice, and topical creams). Since I was so baffled by being declined due to alopecia, I've reviewed all my claims to see how much it cost them. The only thing that seems high cost wise is that one of my doctors prescribed Protopic Ointment and Clobetasol Foam. I only had the prescriptions filled once (back in '09), but I guess they don't take that into account.
Since I've had 18 months of continuous coverage, insurance companies have to cover pre-existing conditions. I'd be happy to decline coverage for alopecia if it would enable me to get health insurance (but I don't think it works that way).