Sponsor This PageClick here to find out how

Why Do Insurance Providers Limit Coverage?

A follower recently asked Stroke-Network.com why insurance companies would not cover particular items that are proven to be effective for stroke recovery, in his case, the Bioness L300 and H200.

Just as your health insurance provider can require that you choose a particular doctor or specialist, they can also dictate what equipment they will and will not cover. This is an effort on the insurance companies part to maintain affordable premiums.

“It can be frustrating as a policyholder,” said Doug Ross, President of Empower Long Term Care Insurance. “But the insurance company has rules, processes and vendors to contain their costs and ultimately their premiums. There is line between the insurance company’s interests and policyholder’s interests where the best product is affordable for the most people.”

The thing to understand about insurance companies as a business is that they make their profit by distributing risk across a pool of people. “The fact that some people end up not needing the coverage is what allows people who need coverage to receive it,” Ross said. “If a feature was built in to a policy that everyone was going to use the insurance company would need to build that in to the rates and then the coverage may not be affordable.”

If you feel that you are being unjustly denied coverage you can try reaching out to the “exceptions” department of your insurance provider. You can also request to work with a case manager for chronic illness. The social service department at your regular treatment facility or hospital can also help negotiate these situations.

By: Kayleen Cohen, Stroke-Network.com

^ back to top

"The thing to understand about insurance companies as a business is that they make their profit by distributing risk across a pool of people."

More on Insurance:

Is Long-Term Care Insurance Available to Stroke Survivors?

Unfortunately, stroke survivors and many others with pre-existing medical conditions cannot pass the underwriting process for long-term care insurance. Find out why and explore other long-term care insurance options here.

What is Critical Illness Insurance?

Critical Illness plans were designed to provide a source of income for the insured when diagnosed with a critical illness such as stroke. Find out how CII covers stroke recovery here.

Empower Services Encore Box Ad Your Ad Here