What Is Health Insurance Screening?

Health insurance screening is the process by which an insurance company determines individual eligibility for their health insurance. Insurance companies establish a screening process to limit their financial liability and responsibility of providing insurance to people with pre-existing health conditions.

Definition

Health insurance screening is a medical check-up, or the acquisition of medical records required by health insurance companies. The purpose of this screening is to assist insurance companies in decisions about who to insure. An insurer can decline the offer of health insurance to a patient who may pose a high financial risk. Alternatively, an insurer may use the health screening as a method for setting insurance premiums, which are generally higher for older individuals or those with chronic conditions. 

Requirements

Individuals in need of private health insurance must be willing to comply with an insurance company's request for medical records or a medical exam. A patient who has a chronic health condition will have higher medical expenses than a young person who never visits the doctor. Health insurance companies have specific formulas for assessing their long-term financial risk with patients of particular age groups and health conditions. 

Challenges

Some individuals and political groups argue against the need for health insurance screenings. When an insurance company is allowed to deny coverage to patients, it limits the patient's ability to access vital medical care. Governments in some countries offer assistance to individuals in this category. While the medical coverage in public health programs may also contain health screenings, these are generally not geared towards limiting a patient's access to medical treatment.