What Top 10 Conditions Are Declined by Medical Insurance?

Health insurance is designed to help individuals pay for medical and health care, but getting covered isn't always easy, especially for those who have medical conditions that may make them undesirable for coverage by major health insurance carriers. When applying for health insurance, most carriers request thorough details regarding current and past medical conditions, which help them determine the potential cost outlay for that given individual. Understanding what some medical conditions may hinder or prevent a person from being covered may help individuals better search for carriers that may offer affordable coverage rather than risk being declined.

AIDS/HIV

A person diagnosed with HIV or AIDS may have an extremely difficult time finding a health insurance carrier who will help cover basic medical expenses. HIV and AIDS bring with it multiple system involvement that includes but is not limited to chronic infection, pneumonia, digestive and breathing issues.

Muscular Dystrophy

Because of the myriad of medical complications associated with muscular dystrophy, a disease that gradually and steadily eats away at muscles, many insurance carriers hesitate to cover those diagnosed with the disease.

Chronic Kidney Failure

A person who is diagnosed with chronic kidney failure, caused in some cases by diabetes, high blood pressure and other conditions, is required to undergo daily dialysis treatments to help filter wastes from the body. According to the American Association of Kidney Patients, costs for one treatment of dialysis may range from between $750 for home dialysis treatments or $1500 at a dialysis center. Costs may average about $30,000 a year.

Cancer

Any type of cancer may cause an insurance carrier to think twice about coverage. Cancer drugs and therapies are extremely expensive, with medications alone often amounting to several thousand dollars a month. According to "The New York Times," Avastin, one of the latest for treatment of breast, colon and lung cancer, can averages about $8,000 a month.

Hemophilia

Hemophilia is a blood disorder that promotes excessive bleeding even in minor injuries. Afflicting mostly males, drugs that help the blood to clot can cost as much as or over $300,000 over the lifetime of the patient, according to the National Institutes of Health.

Myasthenia Gravis

Myasthenia Gravis is a neuromuscular condition that causes an increasing weakness in muscles and voluntary muscle movement. According to the Neuromuscular website, costs and treatment of this progressive disease are moderate to high, resulting in increasing costs of care for patients and insurance companies as time progresses.

Hodgkin's Disease

Hodgkin's disease is a condition that affects the lymph system, affecting function of organs, such as the spleen, liver and lymph nodes with a progressive type of anemia. Considered a type of cancer, Hodgkin's disease patients may see increased costs as symptoms appear and condition advances.

Cirrhosis

Cirrhosis of the liver is caused by excessive drinking and may lead to a decline or total failure of the liver to function, which in turn causes a variety of medical conditions. In some cases, the only course of treatment may be a liver or live-liver transplant, which may cost hundreds of thousands of dollars, causing an insurance company to think twice about offering coverage.

Paralysis

Anyone who is partially or totally paralysed, (paraplegia or quadriplegia) requires specialized care, therapies and treatments, as well as equipment necessary for breathing and other bodily functions. Costs of care on an annual basis may be astronomical, leaving insurance carriers hesitant to offer coverage.

Systemic Lupus

Lupus is a condition that causes chronic inflammation of bodily tissues, and is classified as an autoimmune disorder. The condition may affect multiple body systems and organs, including the nervous system and the lungs, heart or kidneys, requiring constant and in-depth specialized long-term care that according to the Rheumatology Oxford Journal may reach over $13,000 a year.

References

Article reviewed by JPC Last updated on: Dec 15, 2009

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