HOW DO I KNOW IF I WILL QUALIFY? MEDICAL UNDERWRITING is based on three major ingredients: Control, Severity, and Stability of a condition. Underwriters also consider lifestyle as another factor; for example, being able to drive is a good indicator of independence. Medication and number of health conditions weigh heavily in underwriters’ decisions. Contact your marketer or call the underwriting department of the carrier under considerationREMEMBER TO LIST ALL CONDITIONS AND MEDICATIONS. When listing medications indicate dosage, length of time proposed insured has been on medication, number of times medications have been changed, etc. INSURANCE COMPANIES WILL GENERALLY LOOK AT Insurers are committing the value of the policy, so they at least want to be sure that their benefit payments to your clients our not an immediate claim. Companies anticipate that a claim will be filed in seven years, although some carriers consider that time to be shorter. Carriers know they cannot expect perfect health; however they are looking for reasonably good health in order to issue a policy. Most insurance carriers wants to know about you in three (3) areas:
In most cases you will not have to go in for a physical. A medical evaluation is done by having your doctor release a your medical history, including the very recent past and current history. In addition you will be asked a series of questions by representative of the company. A few carriers are beginning to require saliva tests for HIV detection. In some cases it is necessary to conduct a Face To Face Interview, which essentially is a verification of what the information the agent has been given from you. A specially trained health care professional will come to your home to ask a series of questions about your daily activities. This will usually include a short term memory evaluation. The visit lasts about 30 minutes. However, the majority of companies will conduct this interview via telephone. If a preferred company turns you down, it is advisable to consult with one or two other carriers concurrently. It may be the best alternative to get you approved. To be turned down initially by a carrier is an important warning note to you and your family; however, it doesn't necessarily mean you will be rejected by all other carriers. Make sure you understand that if one of them cannot obtain insurance that half of a pie is better than no pie at all. Many times the healthy spouse will become ill while taking care of their mate, in which case you will be spending twice as much if neither of you have insurance. AGE This varies with the insurer. The most common ages of application are 40 years through 79 years. But many insurers issue up to age 85 years, usually with higher rates and, oftentimes, reduced coverage. Some carriers will issue down to age 18; others up to 95+. The younger the client the higher the value in terms of premium costs. The below 50 age group are good candidates for a return of premium products.HEART ATTACK Most companies want to see a full six months of stability and a moderated diet. If you are on an exercise program you can probably expect to get coverage. However, if it was more than a "simple" heart attack with unstable Angina or Congestive Heart Failure, most companies will probably decline you. Having one valve replaced is usually ok. Two valves replaced will more than likely increase the odds of a decline. Not all companies evaluate exactly the same. Some are more cautious than others, or have had poor claims experiences. Some companies will stretch the envelope if they fell you may pass away before you will need care. ARTHRITIS With mild osteoarthritis you can get coverage. If it's more severe you may have to demonstrate some symptom free or stability time – a period of six months is common. You may be able to get coverage issued -- even though you’re taking cortisone or have had a joint replaced. Severe osteo or rheumatoid arthritis, where surgery is necessary, is uninsurable. All individuals have arthritis at some level, and are issued Long Term Care policies every day. DIABETES If you have Diabetes, you will be very difficult to insure. The problem is diabetes breaks down the immune system, causing the healing and recovery process. In general, if it’s a mild case or if your client is not insulin-dependent or (or sometimes, even if they are, but with low dosage), you may be insurable. Your fasting blood sugar will need to be low or manageable at under 200. In addition, you must not have concurrent circulatory, eye, renal or neurological disease. More severe or advanced cases are often not insurable. You will need to seek professional medical advice for you to complete an underwriting evaluation with an insurer to get the answer. If you are diagnosed with Adult onset at an early age insure as early as possible waiting to long can knock you out later on. CANCER With cancer you may well have to show the insurer that you have had longer periods of stability (symptom free months or years), than you would need for a less complex, less dangerous illness. For example, where there was a breast cancer with malignancy, you may well have to show 60 months of stability, symptom free. However, a mild, non threatening skin cancer, not a dangerous one, might not require any wait time for approval! It really varies. If you have had a cancer diagnosis, it does not always rule out coverage, but you will usually have to demonstrate somewhat longer symptom-free periods before issuance. HIGH BLOOD PRESSURE If your blood pressure is still reasonably low (though elevated somewhat) or if it is well controlled with medication and has been stable six months or more, you can realistically expect a polity to be issued (assuming there aren't other prejudicial illnesses or manifestations). But if uncontrolled, with readings of about 175+ and unstable, not controllable, you are probably not insurable. NOTE: Unfortunately, you may have a disease, illness, or condition, or that prior to being evaluated or "underwritten" for long term care insurance, you will simply be uninsurable. That, of course, doesn't mean the insurer won't pay later on if you are issued a plan and one of these conditions should develop. That's what the insurance is for! Once you're approved there are usually no or few preexisting health conditions not covered as long as they were listed on the application. Remember, the best time to purchase long term care insurance is when you are healthy and relatively young (between 50 & 75).
For Long Term Care Insurance
ARC (AIDS related complex) : within three years
result of injury OK/result of disease unacceptable post infarct angina within three months within three months
on gold or methotrexate or more than 10 mg of Prednisone or restricted physical activity : currently using oxygen or respirator; steroids more than 10 mgs per day : chronic, uncontrolled, attack within six months, or Congestive Heart Failure ): coronary within two months date of last treatment within six months/two years if recurrent. Treatment means surgery, chemo or radiation within six months, or limiting physical activity ): within two years, or more than one episode, or with Diabetes
(current or anticipated) (within six months) general, or frequent episodes Within six months, or with atrial Fibrillation
uncontrolled, or on medication less than six months uncontrolled, or with severe circulatory conditions, or with prior stroke (kidney) causing functional limitations requiring oxygen, or with shortness of breath or smoking : frequent, or recurrent within two months if no post infarct angina or complications. Within six months if no post infarct angina or complications. currently being treated (Type B, C, D, E or Type unknown) if newly diagnosed, postpone application for six months. After six months and with documented control. within three months : within six months : current
requiring assistance (systemic or disseminated) : catheter, respirator, oxygen
psychosis or uncontrolled, schizophrenia, depression – stable for six months for no hospitalization
severe, or with history of skin ulcers within two years
with compression fractures within six weeks of implantation : paresis
severe, or smoker active, unlimited and permanent, or used to sign application (except Vanceril) on long-term maintenance dosage in excess of 10 mgs see Cerebral Vascular Accident : current |
DQ1100