mykidslovedogs
Full time employment: Posting here.
- Joined
- Dec 13, 2006
- Messages
- 860
A Few Gotchas to think about if you are over 55 and trying to get private, individual health insurance....
1.) Have you had a physical in the past 2 years? If not, you might want to consider getting one. Many carriers will not even consider you for coverage if you haven't had a physical in the past 2 years (especially the ones that offer preferred rating). On the other hand, there are a few carriers that will not disqualify for lack of having had a physical. If you are worried about what the outcome might be, you might want to limit your plan selection to a carrier that is not going to require that you've had a recent physical. Ask a local broker for input.
2.) Common pre-existing conditions that might present a problem with obtaining coverage. (Based on my past experience)
a.) Elevated Cholesterol diagnosed within the past six months. Insurance carriers like to see stability on either a diet & exercise regimen or medication, with controlled results after at least six months of treatment.
b.) High Blood Pressure diagnosed within the past six months. Insurance carriers like to see stability on two or less medications, with controlled results after at least six months of treatment.
c.) Height and Weight. Not a problem in itself, as long as you do not fall into the grossly obese category, but in combination with elevated cholesterol and HBP, a declination of coverage could result due to the combination of risk factors. BMI above 30 will result in a premium rating.
d.) Degenerative disc disease - This is usually going to be excluded from coverage
e.) Osteopenia/Osteoporosis- This is usually going to be excluded from coverage
f.) Basal Cell skin cancers - can result in premium ratings or exclusion riders or a even a decline if treatment was recent (within the past 3-6 months. ). Other skin cancers - usually a decline.
g.) Actinic Keratosis - usually an exclusion or possible premium rating.
h.) Depression/Anxiety - must be out of counseling for at least 1 year, and medications must not have changed over the past 1 year. Likely outcome...exclusion of coverage or premium rating.
i.) History of drug or alcohol abuse or excessive alcohol or DUI within the past 10 years - decline. (Golden Rule is the only one that only goes back 5 years on this, and there are a few exceptions going back only 5 yrs on DUI.)
j.) Any past history of cancer, even if it is cured - almost always a decline.
K.) Hypothyroidism. Never a problem as long as it is being treated with medication.
L.) Arthritis - Osteo - exclusion or decline depending on severity
M.) Arthritis - Rheumatoid - decline
N.) Any combination of four or more conditions that would have resulted in an exclusion, will usually cause a decline. Insurance carriers typically do not like to exclude more than three conditions at a time. If that happens, they will usually just decline.
1.) Have you had a physical in the past 2 years? If not, you might want to consider getting one. Many carriers will not even consider you for coverage if you haven't had a physical in the past 2 years (especially the ones that offer preferred rating). On the other hand, there are a few carriers that will not disqualify for lack of having had a physical. If you are worried about what the outcome might be, you might want to limit your plan selection to a carrier that is not going to require that you've had a recent physical. Ask a local broker for input.
2.) Common pre-existing conditions that might present a problem with obtaining coverage. (Based on my past experience)
a.) Elevated Cholesterol diagnosed within the past six months. Insurance carriers like to see stability on either a diet & exercise regimen or medication, with controlled results after at least six months of treatment.
b.) High Blood Pressure diagnosed within the past six months. Insurance carriers like to see stability on two or less medications, with controlled results after at least six months of treatment.
c.) Height and Weight. Not a problem in itself, as long as you do not fall into the grossly obese category, but in combination with elevated cholesterol and HBP, a declination of coverage could result due to the combination of risk factors. BMI above 30 will result in a premium rating.
d.) Degenerative disc disease - This is usually going to be excluded from coverage
e.) Osteopenia/Osteoporosis- This is usually going to be excluded from coverage
f.) Basal Cell skin cancers - can result in premium ratings or exclusion riders or a even a decline if treatment was recent (within the past 3-6 months. ). Other skin cancers - usually a decline.
g.) Actinic Keratosis - usually an exclusion or possible premium rating.
h.) Depression/Anxiety - must be out of counseling for at least 1 year, and medications must not have changed over the past 1 year. Likely outcome...exclusion of coverage or premium rating.
i.) History of drug or alcohol abuse or excessive alcohol or DUI within the past 10 years - decline. (Golden Rule is the only one that only goes back 5 years on this, and there are a few exceptions going back only 5 yrs on DUI.)
j.) Any past history of cancer, even if it is cured - almost always a decline.
K.) Hypothyroidism. Never a problem as long as it is being treated with medication.
L.) Arthritis - Osteo - exclusion or decline depending on severity
M.) Arthritis - Rheumatoid - decline
N.) Any combination of four or more conditions that would have resulted in an exclusion, will usually cause a decline. Insurance carriers typically do not like to exclude more than three conditions at a time. If that happens, they will usually just decline.
