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American Medical News


Health insurers reject more than a fifth of individual applications

NEWS IN BRIEF — Posted Feb. 18, 2013

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The health insurance industry averages a national application rejection rate of about 22% of individual and family coverage applications, according to an analysis by HealthPocket, a technology company that compares and ranks health plans.

Plans in Montana had the highest rejection rate of about 45% of claims. The next top rejecters were Alabama at 40%, the District of Columbia at 37%, Arkansas at 35% and Alaska at 34%.

“Clearly, there is great variability across states and within states in terms of how frequently an insurer rejects a health insurance application, but nationally it seems to be occurring more frequently than industry analysts had assumed,” said Kev Coleman, head of research and data at HealthPocket. “What is unclear is whether some insurers have increased their declination rate in order to improve risk pool health and profitability prior to 2014, when insurance companies can no longer reject applications based upon health status or preexisting medical conditions.”

HealthPocket analyzed more about 9,450 nonemployer-based plans for families and individuals younger than age 65.

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