When one applies for individual health insurance, the plans are “underwritten” to determine if the applicant qualifies for coverage. If “pre-existing” medical or lifestyle conditions exist, the applications might be “rated-up,” have a condition “excluded” or “denied.”
Issued Standard is the best outcome of an application. It means the policy has been issued, at the price you were quoted, with no modification to the coverage.
An Exclusion is when the health insurance company offers a client a policy but excludes something from coverage. Some common reasons for exclusions are on-going medical issues, such as a knee that needs surgery or a severe case of Asthma. Other reasons for an exclusion might be for the removal of any type of internal fixation (breast implants, screws or plates), certain types of activities like rock climbing and much more.
Rate-up is when a client is charged more than “standard” by the insurance company. Some typical reasons for this are high blood pressure, high cholesterol, body build, tobacco use, poor driving record, etc.
If the pre-existing condition is such that the insurance company feels they cannot issue a policy, the client is Denied.
This whole area of pre-existing conditions is where I spend a lot of my time in finding the right match for my clients. Different companies have different underwriting guidelines. I have actually gotten preferred ratings for many clients who have received a denial from another.
If you have concerns about pre-existing conditions, give me a call at 303-541-9533. I cannot find individual health insurance for every situation, but I promise that you will be better informed for having contacted me.
