I was turned down for medical insurance- it's a private HMO- can they turn people down for any reason?

Question

I have been with Kaiser insurance for more than fifteen years now. I was insured through my mother's employer. Being that I am 31 years old, I understand that they normally cut off adult children being covered at the age of 18 (unless the child is in college). However, I had been covered by Kaiser Permanente up until around November of 2005. I had had coverage since I was around the age of 15. But now, they have cancelled my coverage. Before, when asked why, they didn't provide a clear answer as to why they revoked my coverage. But now, they are saying that it is due to my obesity and high blood pressure. I have basically stayed the same weight all these years. Since the age of 15, I have probably gained about 30 or 40 lbs. Can they legally do this to me? I am very angry that they refuse to allow me to have health insurance now, on the premise that I am "obese" and I have HBP. I am five foot ten, and weigh around 270. It's not like I weigh 800 lbs.- sheesh! What can I do?

Can I sue this insurance company for discrimination? Or, are they allowed to do whatever they please? Are they permitted to discriminate against people for any reason they want to? Where is the fairness in that?

I am also disabled, due to OCD (obsessive/compulsive disorder), and I am also a full time student, and I am a dependant under my Mom. Shouldn't Kaiser allow me to have insurance coverage? I mean, I need the insurance now all the more, since I have hypertension. I desperately need my blood pressure medicine, and I need to see a doctor. It makes me very angry that this company has done this to me, when we have been loyal customers for so many years! We have paid very high premiums for our healthcare. You would think that this company would treat their patients with more concern and compassion.

Answer 1

I'm not sure if I understand it correctly, but were you not supposed to be on your mother's coverage or did you get a separate policy after 18 or after college? If not, maybe their bookkeeping department just figured out you weren't supposed to be covered all those extra years. You should be able to speak with a supervisor to find out the reason for the cancellation. If you have not recently had a physical or some other reason you know that raised a red flag or the age issue, you might be a victim of identity theft. It is better to know the exact reason because it will probably follow you to any insurance company you try to contact.

I see you added that you are a student. Check the insurance policy. There might be a cut-off age regardless if you are a student or not. If your mother is your legal guardian for some reason, maybe she can find out why you are no longer eligible for coverage.

Answer 2

What you describe is awful. I would be angry too. Getting closure is very important to you. I fully understand.
But, (please forgive me for being practical with you) you are 31 years old, you weigh 270, you have high blood pressure (to an unknown degree), you suffer from OCD (to an unknown degree), and you have no medical insurance. That is a very high risk position to be in. With the greatest sympathy, I suggest you focus on getting medical coverage before you work on the things that are in the medical coverage past. I'll try to help you.
You are unlikely to find an insurer presently who will allow you on a regular individual plan because of the risk factors. You absolutely MUST get some of that weight off. That should be your number one personal goal. Use a combination of diet and exercise (ANY diet, ANY exercise) and get down to about 220 and keep it off so you can accurately assert that is your normal weight. At that level, you are at the top end of what insurers call "standard" weight-to-height relationship and we can work on finding you regular health insurance.
But, right now all is NOT lost. There is a kind of medical coverage you can get that will cover you for anything new for a period of up to a year (depending on your state of residence). If you stay healthy, it can be rewritten so that you keep insurance in force. It is short-term medical coverage and the six-month plan that is available at http://www.wavehelp.com/frequently-asked-questions.htm will be what you want. Read that web page thoroughly and click on through to get a quote. REMEMBER, you want a quote on a six-month plan because that plan will (probably) not exclude you due to HBP (the one year plan WILL exclude you for HBP). You will not be excluded because of weight or OCD. However, you will not be covered for HBP or OCD or any other pre-existing condition - only new illnesses or injuries. It is better than nothing and it is really good coverage for what it covers. You pick the doctor, or hospital, or pharmacy you want. There is no network you must stay within.
In summary, there is a solution but a great deal of it depends on you (just like a lot of things in life).
Sincere best wishes.

Answer 3

Insurance is all about risk. If you are a bad driver, you will have trouble getting insured. If you have high blood pressure and are overweight, you present a higher risk to an insurance company. Do you have insurance available through your employer?

Never mind. I see you added that you are a student. I don't know about the law, but an insurance company should be free to do whatever they wish with regard to insuring customers. Insurance is a business. You present a large potential loss to that company.