Humana Is Being A Little Dramatic About Alex's Health

Alex is 24 years old and was laid off last year. He’s trying to sign up for a high-deductible health insurance plan from Humana One, but they’ve rejected him because he’s got a mess of health issues: “At my last checkup I mentioned occasional knee pain, occasional indigestion, and the fact that I experienced palpitations extremely rarely.” Or as Human describes it, “a medical history of bursitis, tendonitis, osteoarthritis, palpitations and irritable bowel syndrome (IBS).”

I am a generally healthy 24-year old male. I had medical coverage hrough my employer, but when I was laid off in 2009, I opted to seek out some cheaper insurance, as COBRA coverage was both unaffordable and excessive for my needs. In December, I applied for a Humana One high-deductible plan through e-healthinsurance.com. After filling out the online forms, I received a call to confirm the information I’d filled online. That went OK. Then I received an e-mail that my application was about to be rejected because they hadn’t received my medical records release form yet. This was strange because I didn’t receive the form in the mail for another couple days. I shrugged and mailed in that form after receiving it.

After roughly two more months of waiting with no response, I received a letter in the mail today, explaining that they’d rejected my application for coverage. They had apparently managed to get my medical records, although they have inexplicably and continually misspelled my doctor’s name. Based on the medical records, they rejected my application because of “…a medical history of bursitis, tendonitis, osteoarthritis, palpitations and irritable bowel syndrome (IBS),” I’d say this rejection was deplorable but not unusual, except for the fact that I’ve never been diagnosed with or treated for any of these conditions. At my last checkup I mentioned occasional knee pain, occasional indigestion, and the fact that I experienced palpitations extremely rarely. The doctor gave me an EKG (seemed excessive at the time) and it came out totally normal. This was all reflected accurately in my records, so I’d say it takes quite a leap of imagination to say that I actually have the history they cited.

Is it common for people to be rejected for having a minor symptom that is nominally shared by a totally different and more serious condition? It seems akin to calling a stress headache “migranes” or a mole “melanoma”…

I’m pretty baffled but not that surprised. Any thoughts or advice over there?