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Monday, 19 November 2012

Eight Rules for Applying for Individual Health Insurance

Frustrated at applying for individual health insurance? Well, you are not alone. As a health insurance agent with over 30 years of experience, I can tell you that applications have only gotten longer over the years. A lot longer. The interesting thing is this though, that getting accepted for individual and family health insurance has actually gotten easier. Many conditions that used to result in a decline are now either approved at the standard rate or with a surcharge, or risk-adjusted rate.

The other factor is in the way questions are asked. For example, the introduction to the health history section of an application used to say, "Have you ever seen a health care provider, had treatment for any of the following conditions", etc. The problem was with the word "ever." Ever means back to birth. Well, who can remember every ailment they had so many years ago? This caused not only a lot of stress for people applying for individual and family health insurance it caused a lot of extra work for underwriters too.
That changed when the insurers stopped using that line as their lead-in. Instead they started confining their questions to specific time frames depending on the condition, with statements like, "Within the past five (or two, or ten etc.) years, have you had... " This was a huge step forward, and dramatically improved the approval rate for individual health insurance applicants. This leads to my first rule:

Rule #1: Read each question carefully. If you had a strained back 6 years ago and the question asks if you had treatment on your back within the last 5 years, your answer is no. If you are not sure when you strained your back, call your doctor's office first and ask them when your visit was. Undoing an incorrect answer after an application has been submitted is far harder than providing the correct information in the first place. And it delays the underwriting process.


Rule #2: Never self-diagnose a past health condition. If you and the doctor discussed the possibility of arthritis but you can't remember if he or she said you actually suffer from it, call their office and ask. You have the right to ask about anything in your medical records, so do not hesitate to ask.

Rule #3: Make sure you have all of the current contact information about your medical providers, like their address, phone and fax numbers. This is very helpful to the underwriters so that they don't waste time searching for the information themselves.


Rule #4: Expect a phone call from the insurer. All health insurers these days prefer to call and speak directly with you. This is faster and cheaper than requesting information from your doctors. It's also a good idea to keep a copy of your application handy so that when they call you'll have what you wrote down with you. They want to confirm your answers and clarify anything that may affect their underwriting decision. Be straightforward but do not volunteer extraneous details that could result in more questions from them.

Rule #5: If you take any kind of prescription medication, make sure you know when it was prescribed, the strength, dosage, and frequency with which you take it. If you take a generic form of a drug, be sure to indicate that. Insurance companies would prefer that you are taking generics, as they are far less expensive and you are far more likely to get a better underwriting outcome.

Rule #6: If using a paper application, be sure to sign in all the places required. This is very important, because the company will mail the entire application back to you if you are missing even one signature. This can be very aggravating, and delay the approval process.

Rule #7: If you apply for individual health insurance online, it's always a good idea to have all your medical history information at your fingertips before you log on to the application site. Many online application programs have a timeout feature, so it you are off looking for details and it takes more than 5 minutes, some will end the session due to inactivity.

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