Question:
I was denied by insurance (Healthlink) because of an AGE requirement.

I was denied by my insurance company (Healthlink Great West) because of an age requirement. I am 21 (22 in May) and they require one to be 25. If I wait until I am 25, I will have even more health problems! The medical management team reviewed my case and they denied it... the letter only stated this reason. That team was with One Health Plan. I need some help on my appeal. Has anyone ever had this happen to them? I have never heard of this before! I left a message with my case worker, but she has not called me back yet. What do I say in my appeal? What are any of your experiences with this? Thank you!! Erin    — Erin Z. (posted on March 31, 2003)

March 31, 2003
OH please appeal. GO to the library page and do a search for appeals you should get a variety of profiles and pages with different appeal letter samples. Just rewrite them to your need and GO FOR IT. I will be thinking of you. I am only 34 and so much in pain from the weight I carry. My legs from the hips down (especially my feet) and my lower back etc. SO do not let them jerk you around! GOD BLESS Jamie
   — Jamie M.

March 31, 2003
I know that Aetna has an age requirement of 18, but that is to make sure that the patient is done growing (in fact, the coverage policy bulletin says "Patient has completed growth (18 years of age or documentation of completion of bone growth)" But 25??? That seems a bit arbitrary. I'd definitely appeal. If you can afford it, hire Walter Lindstrom (http://www.obesitylaw.com)...JR
   — John Rushton

March 31, 2003
I spoke with my mom (I am on her insurance), and she said she thinks it might be because I will be off her insurance at 25. It covers me until I am 25 or out of school, whichever is first. That has to be illegal! I can't think of any other reason for 25! I am done growing, I can make a sound decision... what other reason is there????
   — Erin Z.

March 31, 2003
Hi Erin: Sounds like you have a case of age discrimination. HOWEVER: Insurance companies can put any stipulations in their policies they want. The employers usually set certain limits on coverages since they pay the premiums. How many comorbities do you have? Did your doctor state enough of an urgency to get their decision reviewed? You need to get ahold of your insurance manual and take a look. If they are still idiots about it, find another job (since you are young enough) and make sure the insurance co. will approve you. Good Luck! Meg [email protected]
   — Meg T.

September 15, 2003
They approved my daughter at age 13. Write to me if you wants specifics. They are evil.
   — sandieguy