If your in-box is anything like mine, you are receiving an endless stream of offers for on-line health insurance quotes. If you are perfectly healthy and know enough about health insurance to be able to select a plan that is well suited for your situation, then this system will work well for you.
However, if you are dealing with some, even minor, pre-existing conditions, or you have not been keeping up on all the changes in the health insurance industry, it might behoove you to speak to an experienced health insurance broker like, modestly, me.
Pre-existing conditions? I promise you that different health insurance companies look very differently at certain pre-existing conditions like; depression, asthma, recent operations, gout, build (height vs. weight), DUI’s and many others. An experienced broker can steer you towards the company who will give your application the best chance of being accepted.
The “right” plan? Low priced health insurance plans often have hidden “gotchas.” These might include excessive co-insurance charges, limited or no doctors’ office visits, no “branded” prescription coverage, additional “access fees” for hospital/ER visits, no mental health coverage, etc. Unless you know what you are doing or have someone to point these “holes in coverage” out to you, you may end up buying a policy that excludes the very things you most want covered.
And, best of all, it costs you nothing to work with a broker; the insurance companies pay our commissions. The cost to you is the same either way.
So, give me a call at 303-541-9533, if you want to make sure you are getting the health insurance coverage you are paying for.
Most insurance companies consider health insurance “credible” if it is a group or medically underwritten individual medical insurance policy.
Why is this important?
*If you are moving from one group (usually employer sponsored insurance) to another, and have had previous “credible coverage” that was not interrupted for a period of 63 or more days, most pre-exiting conditions must be cover by the new plan.
*Although individual health insurance companies are not required to cover pre-existing conditions, even with prior credible coverage, they often offer better premium prices and eliminate “wait times” for those with this type of prior coverage.
I believe the reason for this is individual health insurance companies would prefer to offer plans to people who have had continuous coverage because the client will have a greater likelihood of having taken care of medical problems along the way, instead of waiting until they obtain a new policy to get issues attended to.
Many individual health insurance companies do not consider travelers insurance, student insurance and short term insurance credible.
And, you do not want to fib on a new application for health insurance about prior coverage, because if this is found out future claims may be denied.
If you would like to know more about how this might affect you, please give me a call at 303-541-9533.
I am often asked how long it takes to get an application for health insurance approved. The answer is always the same, “it depends on how long the insurance company takes to review or “underwrite” the information you submit. Underwriting is a term insurance companies use that basically means “background check.” Individual health insurance companies have the ability to pick and choose to whom they will offer coverage. So, they require that you fill out an application form, answering a comprehensive list of personal medical and life style questions.
Once they receive this information from you, the underwriting begins. In addition to reviewing the information you have provided, they may plug your Social Security number into something called the Medical Information Bureau (MIB). The MIB is a sort of clearing house that collects patient information from doctors, hospitals, pharmaceutical companies and other insurance companies.
The underwriters may also call the applicant for clarification of details and, if need be, request records from your doctor before they are ready to make a decision on the application. The more information they need, the longer it takes for them to make an offer.
So, the answer to the question of how long it will take to get your application approved is, “usually a week to 10 days if doctors’ records are not required. If doctors’ records are required, it will take as long as it takes for the doctors’ office to respond to this request.”
That is why it is important to work with a knowledgeable insurance broker to fill out an application properly to avoid misunderstandings and delays from the onset.
If you’d like to find out what a professional individual health insurance broker can do for you, please give me a call at 303-541-9533.
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.