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Am
I Insurable |
Individual
and Family insurance is different from Group
(Company) insurance in that they can decline and
or change rates based on your health at the time
of application. Below we have some common
reasons for difficulties in getting approved but
first a few quick tips regarding qualifying for
coverage.
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Some
situations require time away from the
condition in order to qualify. For
simple situations, a 6 month period sign,
symptom, and treatment free is a good
estimate. This can also pertain to
medication.
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It
is not uncommon to be declined by one carrier
and accepted by another even though the
carriers have very similar underwriting
requirements.
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If
we are declined by a carrier, we lose our
Short Term option. If there is an issue,
and you have no coverage, we recommend getting
Short Term coverage first and then apply for
the permanent plan. Get more info here.
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Brand
name medication are heavily scrutinized these
days due to the cost associated with their
use.
- If you are
currently on Cobra, it typically makes sense
to apply for coverage as there is no down
side. You can remain on your Cobra if
the coverage is not approved. Cobra is
usually quite expensive.
- The carriers
can offer a split approval where one member is
not approved but the rest of the family is.
- The carriers
are mainly looking at current/recent and
ongoing situations. We all have a
medical history but situations that are
stable, from which time has passed, typically
do not cause problems.
- If you
are exhausting or losing Cobra (continuation
of group coverage) you may be eligible for
HIPAA. Please check
with us if this sounds applicable.
Some
common reasons for declination/deferrals of
coverage
- currently
pregnant or an expecting father
- multiple
medications especially brand name
- recent
(last 6 months including physical therapy)
injury
- recent
(last 2-3 years) treatment for heart
disease, diabetes, cancer, immune system
disorders, or any other serious medical
condition
- height/weight
outside guideline range
- multiple
conditions/injuries/illnesses
If
you have questions about your preexisting
conditions whether listed above or not, please
call us at 866/444-3332 or email
us to receive personal assistance from a
licensed agent. We will be able to advise you
based on your specific medical history.
Of
course, if you have questions, please contact
us. That's what we are here for.
email: help@texasplans.com
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email
us here
with your questions
or
call:
866/444-3332 |
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