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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Declined Coverage in Texas

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Question: I applied for health insurance with Unicare and they turned around and told me they couldn't cover me. Can they do this? I was covered with them for years through my employer and paid them thousands of dollars in premiums. I only have a little acid reflux and use one prescription called Nexium!! Are they allowed to do this? How do I get them to change their minds about this?

Answer: The answer to your penultimate question is yes, insurance companies can deny you coverage if you do not meet their underwriting guidelines, even if you have had previous group coverage with them. In your position I would not make an appeal as I feel it would waste your time and most likely not garner you a different decision. I suspect you were denied coverage due to the expense of your medication. Even so, I would expect you would be eligible for coverage with a different company either with an exclusion rider for gastric reflux or at a higher premium.

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