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Being Gluten-Free and Staying Covered

› Health Insurance › Being Gluten-Free and Staying Covered

February 6, 2013, by Southern States Insurance

It is widely known that health insurers are not fond of the blemishes and bumps of the general public who purchase their products. Premium rates increase at the slightest glimpse of acne, allergies, or any highly common ailment. Consequently, many people whose digestive systems disagree with gluten admit they are now uninsurable.

As celiac disease has gained a strong presence among Americans, the question arises: how exactly do health insurance companies regard gluten intolerance?

In fact, celiac disease has made the cut for underwriting guidelines (the deciding factor in the application process) in individual health insurance. However, it depends on the carrier, and the degree of your condition whether rates go up or not. Keep in mind, insurers are eager to decline, charge more, and/or impose exclusions if you seem high-risk. We find Aetna to be the most accepting of people with conditions.

Because diabetes is also tied to celiac disease, the answer for anyone with both conditions is yes, you will likely be declined or rated up. Diabetes is often considered by insurers to be a declinable condition — especially Type I, though Type II requiring medication is in most cases declinable, as well.

It truly depends on the individual applicant, their specific history, and what measures have been taken to counteract and treat their health problems. This may give some hope to anyone who is taking care of themselves with a responsible diet and healthy lifestyle, that just because you have a certain medical condition, like the inability to eat gluten, that you will not be subject to more expensive, or limiting, coverage.

 

Tips for When You Apply

Insurers view any condition as a risk. So long as you consider your gluten intolerance a non-issue, don’t mention it unless you want to pay higher premiums. If you take medications, however, you will have to let them know and are therefore subject to increases.

Typically, if you have mastered the art of eating gluten-free, you will sail through the underwriting process smoothly and elude the possibility of rate-ups. As a healthy person with a condition controlled by diet, you win, and get coverage at a “normal” rate.

 

What to Do if You Get Declined

Thanks to the Affordable Care Act, rate-ups will no longer be a problem after 2014. Insurers on the private market and in the new health insurance exchanges will be required to accept anyone for coverage regardless of their conditions, medications, or health status. If you need coverage in the meantime after a decline or rate-up, state and federal risk pools will accept anyone with health problems, like the Pre-Existing Condition Insurance Plan (PCIP).

 

The Good News for Gluten Allergies

With the array of gluten-free foods available, and the popularity of the diet itself (even for those without a health condition), there is a higher possibility that someone with a gluten problem can buy a health plan at a regular cost. If you eat well, stay active, and don’t require medications, you are free to apply with any individual health insurer as a healthy, normal person until the laws change.

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