125 pounds is too fat for health insurance

5th May 2008

125 pounds is too fat for health insurance

I ran into a fellow grad student after class, who has recently switched from the stodgy annuals of European history to gender studies. Amy and I are both presenting papers at an upcoming history conference and I let her know that I found her topic on the sexualization of the Spice Girls interesting. She’s incorporated art history to present a multi-faceted look of the individual Spice Girls with their artistic counterparts. She said she will send me her paper so I could post snippets of it here.

We’re both really interested in the representation of women in mass culture, particularly in fashion and in women’s magazines. Discussion led into how the standards have continually shifted and become higher and harsher for women. And then Amy told me this little anecdote and gave me permission to share here.

In 2006, Amy took a year off school and had to apply for health insurance. I assume she didn’t have a job in which health insurance was available. Amy was denied for health insurance through Blue Cross/Blue Shield for two reasons: She had a preexisting condition of migraines which had required hospitalization twice in 25 years; and she was declared overweight.

Amy stands 5′0 inches and at the time, weighed 125 pounds. Her height and weight placed her BMI at 24.4, which falls within the range the government has deemed to be average.

Amy said she wrote a strongly worded appeal, emphasizing her healthy diet and lifestyle and castigated Blue Cross/Blue Shield for imposing unrealistic standards. She added that she is especially sensitive to the verbiage because as a dancer, she’s seen many of her classmates and friends go on to develop eating disorders. Unfortunately, Amy only received further form letters reinforcing her denial.

“Could you imagine if I wasn’t as confident?” asked Amy. “Being denied health care could have put me right over the edge.”

I have heard of people being denied health insurance for being overweight, but I often hear of these cases at the upper end of the weight stratum, usually with the obese or morbidly obese. The fact that one can be well within average weight standards and yet be declared overweight and denied health care is mind-boggling.

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This entry was posted on Monday, May 5th, 2008 at 7:08 pm and is filed under Fat Bias, Health/Nutrition. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

1 On May 5th, 2008, Entangled

said:

Wow. Thing is, much as the standards for looks shift downward and downward, those standards are actually fairly unhealthy. One would think that even if a health insurer buys into the conventional obesity = d00m mentality, they’d at least have the sense to look at longevity data and realize that the heavier end of healthy - the lower end of overweight tends to correlate with the best outcomes.

This is beyond mind-boggling. Part of me wants to be pissed off, but another part is just too damn boggled. Health insurers aren’t really known for acting in the best interests of their customers, but generally they’re pretty good at serving their own interest, which I’d think getting premiums from a healthy young person does.

posted on May 5th, 2008 at 8:21 pm

2 On May 5th, 2008, littlem

Has she called an attorney yet? I don’t know what the statutes are like in your state, but that SO smacks of bad faith denial to me.

posted on May 5th, 2008 at 8:40 pm

3 On May 5th, 2008, Kate

Seriously? SERIOUSLY??????? This boggles my mind–they REJECTED her for having a NORMAL BMI?!?!?!?!?!? That is the biggest bunch of bullcrap I’ve ever heard. Requiring a weight below what even the (fat-o-phobic) medical profession deems perfectly healthy and fine?! Holy crap. I’m glad she was able to stay strong and see the how utterly ridiculous that is…frankly, it would have destroyed me.

It’s especially ridiculous because at only 5 feet, five pounds is worth a full BMI point. So maybe first thing in the morning she’s insurable but by nighttime, nah.

Any idea what BMI they require to be considered “healthy?” Because that seriously blows my mind. I wonder…do they have a similarly stringent standard for minimum BMI? Or is it just lower=healthier! Yay, you’re starving to death!

It’s a little weird to realize I’m about 12 lbs below being too-fat-for-BCBS-to-insure…and about 12 lbs above doctor-hospitalizes-me-for-ED. But at that lower weight…BCBS would be only too happy to cover me! (And then refuse to pay for inpatient as not medically necessary b/c my doc’s idea of my minimum acceptable weight is definitely above the minimum BMI for my height…b/c apparently at a BMI of 18.5, given the fact that I am bizarrely dense, I would be (her words, not mine) “dead.” Which I suppose is a lot cheaper for the insurance co…)

Then again, I’m uninsurable as well. Yay for ED! Yay for the fact that my state has a high risk pool where I pay through the nose for ridiculously expensive (but quite good) insurance–ironically, through BCBS. :-/

Sorry for ranting. Insurance companies SUCK.

posted on May 5th, 2008 at 9:46 pm

4 On May 5th, 2008, Rachel

Insurance companies do suck. I think Amy gave up after being denied again and again. I think she now has insurance through our university. Our university requires all students to have insurance, either private or through the college. Because they require it, they cannot deny you on their plan.

posted on May 5th, 2008 at 9:48 pm

5 On May 5th, 2008, bookwyrm

If by all conventionally accepted standards (no matter what we actually think of those standards) she is within acceptable weight, then the denial has no validity on its face and should be actionable.

posted on May 5th, 2008 at 10:05 pm

6 On May 6th, 2008, Meowser

OK, every “ZOMGALLTHEFATZKILLINGMYINSURANCEPREMIUMS!!111!!” person on earth really NEEDS to see this. People do not get that what is considered “healthy” is not a fixed thing; the ante is constantly getting upped and upped and upped. If there were no “obese” people, then society would focus its wrath on thin and average-sized people with high blood pressure and high cholesterol. And what’s considered “high” will be ratcheted down and down and down and down and down.

posted on May 6th, 2008 at 12:08 am

7 On May 6th, 2008, AmyP

This post is not truthful.

From the Blue Cross Blue Shield website:

Can I be denied coverage because of a medical condition?

Blue Cross Blue Shield individual health care plans are not medically underwritten. This means you will not be excluded from coverage because of medical history or current health status.

posted on May 6th, 2008 at 2:34 am

8 On May 6th, 2008, Jackie

It is unbelivable. If I were Amy I’d have wanted to ask them, “So now do you pay for extra care resulting from the inevitable eating disorder one would have to have, to be the proper weight for your insurance?”

posted on May 6th, 2008 at 3:23 am

9 On May 6th, 2008, Rachel

AmyP - Keep in mind, this was two years ago. The company may have revised its policies since. But as it is, I did not ask Amy to furnish proof of the denial. This is how she perceived her situation, led by her interpretations of paperwork received.

posted on May 6th, 2008 at 8:26 am

10 On May 6th, 2008, Fauve

I’m so repelled by this country’s healthcare systems. They suck in so many ways. It’s disgusting that a woman at 125 pounds was deemd too “overweight” for health insurance. The fact is, that Everyone deserves health coverage, regardless of weight.

posted on May 6th, 2008 at 8:53 am

11 On May 6th, 2008, corinna

I have insurance through my husband’s work and New York State employees have excellent coverage. We are very lucky because we never hear a work about our weight from doctors and we are both big people.

Rachel please write me at my e-mail address. I have lost all my received e-mail and my address book is wiped. This is what happens when you change your hosting. I had no idea!

posted on May 6th, 2008 at 9:31 am

12 On May 6th, 2008, Bree

Blue Cross DOES turn down people for insurance. I live in Maryland and my state’s BC (CareFirst) turned me down due to BMI and a family history of heart disease and diabetes even though I don’t have any of these pre-exisiting conditions. I was told the only insurance I could receive was Maryland’s insurance for “high-risk” citizens, at over $200 a month in payments and a $5000 deductible. This was 2 years ago, BTW.

I could have appealed, but decided not to because many insurances today deny coverage for being fat, even if you are in good physical health. Since my work does not provide health coverage right now, we get phone calls from companies. I flat out told one company that CareFirst denied me due to my weight and asked them if they would do the same. They said they wouldn’t, but this was a year ago so know knows if their policies have changed.

Insurance companies should not have the right to deny coverage to people simply because of size, whether it’s a 125 lb. person with migraines or a 400 lb. person with no health problems. They need to stop buying into the hysteria of fat people eating up health care costs AND they need to stop using the BMI as a tool of health. Otherwise, most athletes would be refused.

posted on May 6th, 2008 at 9:57 am

13 On May 6th, 2008, anonymous fat girl who pays for her own insurance

I had the “fat” penalty when I purchased my own health insurance through Assurant Health. With no other health problems, a normal bp & cholesterol, I was deemed high risk because of a BMI in the obese category. Not only did you pay for being “too fat,” if you had been “too fat” at any time in the last 10 years.

I had to pay double the premium otherwise quoted, and that premium went up every year. I was completely traumatized by the whole event, no matter how much I loved myself and new that my health was good, no matter how much I knew that I was the victim of discrimination, I felt shame.

During the period of time I was with this insurance company,I was diagnosed with a thyroid condition. The subsequent treatment caused my weight to fall back into “overweight” BMI. With much trepidation I sought out new health insurance, and this time I was spared the “fat” penalty. I was not asked about the last 10 years, but I fear that this may still be an issue.

I choose to post anonymously because I fear that I will be denied coverage or be asked to double this premium should my “too fat” history become known.

posted on May 6th, 2008 at 9:57 pm

14 On May 6th, 2008, Arielle

Wow. This story made me shake my head in bewilderment. I currently have Blue Cross Blue Shield and one would think that will a history of anorexia nervosa I would be more likely to be denied coverage than a healthy 125 lb. woman. I am glad she fought back by writing to them, but I am sorry it was to no avail.

I can’t say I’ve ever had a problem with BCBS, but everyone’s experiences are different and I’m sorry she had to go through this.

It could certainly have sent her “over the edge” had she been struggling with an eating disorder or severe body image issues.

Wow.

posted on May 6th, 2008 at 11:23 pm

15 On May 6th, 2008, Arielle

Meant WITH a history of anorexia nervosa…

posted on May 6th, 2008 at 11:24 pm

16 On May 8th, 2008, Emily

The “health care” industry is absolutely ridiculous when it comes to weight and treatment for things like eating disorders. When I was diagnosed with anorexia, all my insurance would cover was 25 outpatient psychotherapy visits (with a $15 copay) and unlimited 15-minute visits with my internist (also $15 copay). That’s it. However, if I had needed to be hospitalized for electrolyte imbalance or, god forbid, suffered a heart attack, that would be covered. Apparently they never heard the old adage “an ounce of prevention is worth a pound of cure.”

posted on May 8th, 2008 at 8:42 am

17 On May 10th, 2008, Rani

Insurance companies are in the business of turning people and treatment down. They hire people, even doctors, to decline medical care coverage. In other words, a patient who has a certain X condition that his doctor says he needs Y treatment, they try to decline it if at all possible. They are businesses, and there to make a profit. Period.

posted on May 10th, 2008 at 4:45 pm

18 On May 12th, 2008, Weight loss: A matter of choice? « spacedcowgirl said:

[...] understand how fundamental some of these issues are. I mean, for god’s sake, they’re denying people health insurance, and it looks like it won’t be long before they start taking people’s children away. [...]

posted on May 12th, 2008 at 3:49 am