Nobody likes rejection. And it really feels bad (and scary) to be rejected, officially called "declined," for health insurance coverage. We agents don't like it either, but it's a fact of life in our world and one we have to help clients with.

If you've been upfront about any health issues during early discussions with your agent, he or she should be able to give you an idea of what to expect in terms of underwriting outcomes. Most (but not all) carriers make available to agents a list of conditions that will trigger an automatic decline. Sometimes, however, there is more gray area, particularly when it's the additive effect of multiple conditions rather than any one single condition that is cause for decline. And for some carriers (the ones who don't give us underwriting guides), we pretty much have to base our recommendations on a combination of other carriers' guidelines and past experience.

In North Carolina and South Carolina, the two states I cover, the Plan B in the event of a declination is a state high risk pool. While not inexpensive (particularly in South Carolina), the risk pool plans at least offer an alternative to going uninsured.

On a couple of occasions, I've been able to find a short-term plan that would at least provide basic coverage until other coverage, either Medicare or an employer group plan, can be obtained. However, this isn't a perfect solutions, as short-term plans, while at least affordable, don't cover pre-existing conditions. And often, the same health issues that caused the original decline will also render the individual ineligible for short-term coverage.

This is one of the major issues that we in the health insurance industry would like to see addressed by Congress. If they would at least level the playing field and require certain things of all insurers, I really do think there is a solution for this part of the healthcare puzzle.