Heavy 4-Month-Old Denied Health Insurance

[Theophylact]

This is what our current "health" "care" "system" does:

Quote:

GRAND JUNCTION — Alex Lange is a chubby, dimpled, healthy and happy 4-month-old.

But in the cold, calculating numbered charts of insurance companies, he is fat. That's why he is being turned down for health insurance. And that's why he is a weighty symbol of a problem in the health care reform debate.

Insurance companies can turn down people with pre-existing conditions who aren't covered in a group health care plan.

Alex's pre-existing condition — "obesity" — makes him a financial risk. Health insurance reform measures are trying to do away with such denials that come from a process called "underwriting."

"If health care reform occurs, underwriting will go away. We do it because everybody else in the industry does it," said Dr. Doug Speedie, medical director at Rocky Mountain Health Plans, the company that turned down Alex.

By the numbers, Alex is in the 99th percentile for height and weight for babies his age. Insurers don't take babies above the 95th percentile, no matter how healthy they are otherwise.

"I could understand if we could control what he's eating. But he's 4 months old. He's breast-feeding. We can't put him on the Atkins diet or on a treadmill," joked his frustrated father, Bernie Lange, a part-time news anchor at KKCO-TV in Grand Junction. "There is just something absurd about denying an infant."

Bernie and Kelli Lange tried to get insurance for their growing family with Rocky Mountain Health Plans when their current insurer raised their rates 40 percent after Alex was born. They filled out the paperwork and awaited approval, figuring their family is young and healthy. But the broker who was helping them find new insurance called Thursday with news that shocked them.

" 'Your baby is too fat,' she told me," Bernie said.

Up until then, the Langes had been happy with Alex's healthy appetite and prodigious weight gain. His pediatrician had never mentioned any weight concerns about the baby they call their "happy little chunky monkey."

His 2-year-old brother, Vincent, had been a colicky baby who had trouble putting on pounds.

At birth, Alex weighed a normal 8 1/4 pounds. On a diet of strictly breast milk, his weight has more than doubled. He weighs about 17 pounds and is about 25 inches long.

"I'm not going to withhold food to get him down below that number of 95," Kelli Lange said. "I'm not going to have him screaming because he's hungry."

Speedie said not many people seeking individual health insurance are turned down because of weight. But it does happen. Some babies less hefty than Alex have had to get health endorsements from their pediatricians. Adults who have a body-mass index of 30 and above are turned down because they are considered obese.

The Langes, both slender, don't know where Alex's propensity for pounds came from. Their other child is thin. No one in their families has a weight problem.

The Langes are counting on the fact that Alex will start shedding pounds when he starts crawling. He is already a kinetic bundle of arm- and leg-waving energy in a baby suit sized for a 9-month-old.

They joked that when he is ready for solid food, they will start him on Slim-Fast.

Meanwhile, they made Alex's plight public on KKCO this week. They plan to appeal Rocky Mountain's denial.

If that doesn't work, they plan to take their case to the Colorado Division of Insurance.

"My gripe is not with Rocky Mountain," Bernie said. "It's with the general state of the health care system."

[pickel]

Forum policy prohibits me from expressing my opinion

[no1_vern]

As soon as I see that any of the "new" systems will be better than what is in place, I will give them serious consideration. Until then, this is it.

[The Real Bingo]

I don't get that. Too high risk? You can price risk. Why can't he be insured? (unless there are caps imposed on the premiums charged by insurers...?)

[Steve R Jones]

Rocky Mountain Health Plans changed their tune and their policy to "all healthy babies regardless of weight will be insured."

[MegalosSkylaki]

Quote:

Originally Posted by Steve R Jones

Rocky Mountain Health Plans changed their tune and their policy to "all healthy babies regardless of weight will be insured."

What do you think the chances of their having done that had it not drawn the publicity AND compare that to the odds of trying to achieve the same thing quietly by some other ploy?

MegalosSkylaki
Your Purple DooG,
On a Monday Evening.

[Steve R Jones]

Just so happens that DAD is a TV Newsguy

[Whir]

If the system is keeping you down, use what you can to beat it. Good on him.

[SiliconJon]

Rape Victim's Choice: Risk AIDS or Health Insurance?

Insurance IS fraud, but we could make their profit reaping fraud illegal. Instead I see us going down an opposite path - debating mandatory donations to these frauds of companies.

[Chuckiechan]

Quote:

"I'm not going to withhold food to get him down below that number of 95," Kelli Lange said. "I'm not going to have him screaming because he's hungry."

This isn't going to end well.

BTW, has she tried the SCHIP program? No not ChoclateCHIP, the other one!