A mother in Sweden was very surprised when her insurance company denied health insurance coverage to her daughter. Despite being a normal weight for her height, the daughter has been classified as obese. Could an insurance company in the United States do something like this?
Zarah Samuelsson lives in Sweden, and has a five year old daughter named Freya. She got a letter back from her insurance company, (Folksam), stating that they have refused to renew her daughter’s health insurance policy. At first, she thought this was a joke, but it turned out to be very real.
The reason given by Folksam was that the insurer decided that Freya’s weight put her into a “seriously overweight / obesity” category. They consider her to be high risk, and therefore, will not cover her at this time. Folksam told the mother that they can apply for a new health insurance policy one year from now. However, the policy will only be approved if Freya is the same weight at that time as she is today.
Perhaps the strangest part of this story is that Freya is neither overweight nor obese. She is three feet five inches tall. She weighs 55 pounds. Plug those numbers into the BMI (body mass index) chart and you can see that her BMI is 23.0. This puts Freya into the category of “normal weight”, which includes a BMI range of 18.5 to 24.9.
Could this happen with an insurance company from the United States? My best guess is that insurance companies in America cannot refuse health insurance coverage to children who are considered to be obese. The Affordable Care Act put regulations in place that prevent situations like the one in Sweden from happening here in the United States.
On September 23, 2010, a new law went into affect that prevented insurance companies from denying health insurance coverage to children due to the child having a pre-existing condition. This includes all children who are under the age of nineteen.
This law took effect on all new health insurance plans that were purchased after March 23, 2010, and for all existing group health insurance plans. So, assuming that an insurance company decided that obesity was a “pre-existing condition”, it would not give them the right to refuse health insurance coverage to that child.
On January 1, 2014, another law will take effect that will provide that same protection to all Americans. After that date, insurance companies will be prohibited from refusing health insurance coverage, (or to renew existing health insurance policies), to anyone, child or adult, due to the person’s pre-existing conditions. They also will no longer be allowed to charge a person a higher rate because of their health status, or because of their gender.
Image by -Paul H- on Flickr