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Medicare Supplement Underwriting: Are You Eligible to Buy a Medigap Policy? - YouTube
Channel: BCMWI - Medicare Plan Specialists Since 1976
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in most states once you are beyond the
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first six months on medicare part b you
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usually have to answer a list of health
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questions and provide a list of your
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medications on a medicare supplement
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also known as medigap application then
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that application is sent to an
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underwriter at the insurance company who
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determines whether or not you are
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eligible to purchase
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a new medicare supplement this can be a
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nerve-wracking experience but it doesn't
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have to be in this video we'll go
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through what kinds of questions are
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asked on medicare supplement
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applications which medical conditions
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are likely to result in a denial which
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medical conditions are not a problem for
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medicare supplement underwriting and the
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situations when you don't have to go
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through underwriting at all in order to
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purchase a medigap policy hi i'm tabitha
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moldenhauer broker with benefit
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consultants midwest if you haven't
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already please take a moment to hit the
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subscribe button we have new helpful
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medicare content every week your first
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six months on medicare part b are your
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medicare supplement open enrollment
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period during that time you are able to
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purchase any medigap policy sold in your
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state without having to answer any
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health questions or provide a list of
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your medications so the first question
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is why would you be purchasing a
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medicare supplement once you are beyond
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your first six months on medicare part b
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there are many reasons why this happens
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people successfully get through
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underwriting to purchase new medicare
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supplement policies all the time if
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you've had a medigap policy for a few
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years and the rates have gone up you may
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be purchasing a new medigap policy in
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order to keep the same level of coverage
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but
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have a new lower monthly premium or you
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might decide to change your medicare
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supplement coverage from a plan f to a
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plan g or from a high deductible plan g
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to a plan n just to give a few examples
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or you may have been in a medicare
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advantage plan and switched back to
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original medicare parts a and b and want
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to add medigap coverage what kinds of
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questions are asked on the application
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every insurance company has slightly
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different health questions this is to
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your advantage when working with a
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medicare plan broker your broker can
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compare questions from several different
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companies to find the one most likely to
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accept your application the health
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questions are usually very
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straightforward the notes and
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instructions on the application tell you
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if your medical condition will result in
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your application being declined if
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that's the case you know before even
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completing the application that applying
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to that particular company would be a
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waste of time with some health
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conditions the medicare supplement
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company will consider your application
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but it does have to be sent to an
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underwriter who may call you or your
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medical providers for more information
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in deciding whether or not to accept
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your application what medical conditions
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lead to an application being declined as
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mentioned earlier every insurance
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company has slightly different
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applications but in general the
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following conditions are likely to cause
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an application to be declined number one
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necessary medical treatment that has not
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been performed yet this is a knockout
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question for most companies if your
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doctor has told you that you need
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surgery testing or treatment that hasn't
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been done yet finish your testing and
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treatment before applying for a medigap
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policy number two currently hospitalized
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confined to a bed in a nursing facility
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or assisted living or receiving home
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health care if you fall into any of
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these categories you will most likely be
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declined if your situation is temporary
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you may be able to pass underwriting
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once all treatment is done and you are
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completely recovered number three
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currently being treated for internal
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cancer usually insurance companies will
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decline your application until you have
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been cancer free for two years there is
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some variation depending on the type of
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cancer from one company to another
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number four recent medication changes
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these may or may not be a problem
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depending on the insurance company and
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the medication if your medications have
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been the same for more than two years
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you shouldn't have a problem however if
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your medical condition is not under
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control and your doctor is still trying
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to find the medications that will work
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for you that may lead to a decline
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number five serious chronic health
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conditions again each company varies
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slightly but if you have any of the
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following you are unlikely to be able to
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pass underwriting for a medicare
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supplement policy rheumatoid arthritis
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insulin dependent diabetes with cardiac
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complications
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ms aids osteoporosis with fractures copd
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and other severe lung disorders dementia
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parkinson's disease als
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serious heart problems heart attack
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stroke tia
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stent placement valve replacement
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pacemaker congestive heart failure
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kidney failure and organ transplants
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other than corneal transplants which
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medical conditions are generally not a
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problem for medicare supplement
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underwriting number one high blood
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pressure and cholesterol unless these
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conditions are severe and require far
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more than the usual medication to
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control they aren't a problem for
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passing medicare supplement underwriting
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number two
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osteoarthritis while rheumatoid
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arthritis is a declinable condition
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osteoarthritis is not number three bmi
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medigap applications do usually ask for
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your height and weight but underwriting
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is pretty lenient as long as you are not
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seriously obese a high bmi on its own
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will not cause your application to be
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declined number four type 2 diabetes not
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requiring insulin if you are taking
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medication for type 2 diabetes but don't
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need insulin and don't have any cardiac
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complications you can pass underwriting
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for a medicare supplement number five
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mental health medications
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if you take prescriptions for anxiety or
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depression you can pass underwriting
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provided you have not needed inpatient
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mental health care number six some types
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of cancer if you have certain types of
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cancer you can be approved for coverage
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with some medigap insurers this varies
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from one company to another so ask a
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broker to research options for you if
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you find yourself in this situation
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underwriter phone calls and medical
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records checks as part of the
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underwriting process your underwriter
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may call you to confirm the answers that
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you gave on your application it's
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important to both fill out the
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application honestly and respond to
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underwriter questions accurately and
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honestly on the application you agree to
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give underwriters access to your medical
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records so any discrepancies will be
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easily discovered the underwriter is
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only allowed to ask the same questions
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that were asked on the application keep
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responses simple and short
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sometimes medicare supplement applicants
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say far too much on underwriter phone
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calls and end up being declined based on
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information they gave that the
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underwriter didn't request once my
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application is in underwriting can i
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assume i'm approved no do not assume
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that your medicare supplement
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application has been approved until you
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receive
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written confirmation of that
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underwriting can take up to three weeks
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during that time do not cancel your
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current coverage just in case your
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application is eventually declined if
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you are approved you will receive your
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policy or id number and a copy of your
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policy either electronically or in paper
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form once you have that it's safe to
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cancel your other coverage if you are
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replacing a different medicare
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supplement your old policy will not be
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automatically cancelled you need to
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contact your old insurance company and
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request the cancellation what if my
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application is declined that's not the
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end of your options every company
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handles underwriting differently there
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may be another medigap company that will
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accept you when someone is declined the
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underwriter can tell that person what
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issue caused the application to be
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declined and then your broker can look
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for a medigap company that may be more
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accepting of whatever condition caused
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your application to be declined in some
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areas there are also guaranteed issue
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medicare supplement companies that
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accept everyone who is age 65 or older
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and has medicare parts a and b
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another option is to keep your current
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coverage until the annual enrollment
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period begins in october and then look
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at medicare advantage plans available in
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your zip code are there times when you
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can switch medicare supplements without
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having to answer health questions yes
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there are guaranteed issue situations
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when you can purchase a medigap policy
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without having to answer any health
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questions or providing a list of your
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medications examples of guaranteed issue
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situations include
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leaving an employer group health plan
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moving away from the service area of
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your medicare select or medicare
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advantage plan or if you tried a
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medicare advantage plan for the first
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time and chose to return to original
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medicare within the first 12 months
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there are also state-specific laws that
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allow bypassing underwriting for example
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in washington state you can switch from
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a medigap plan a to another medigap plan
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a or from a medigap plan letter b
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through n to another medigap plan
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lettered b through n at any time
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without having to answer health
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questions or provide a medication list
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going through medigap underwriting can
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be stressful it is much easier and more
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likely to succeed in you being approved
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for new coverage when you have a
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knowledgeable experienced broker on your
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side who knows the underwriting
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differences between companies and can
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help you find a plan that fits your
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needs and budget and is most likely to
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accept your application if you have
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questions about your medicare supplement
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or any other medicare coverage please
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feel free to give our office a call
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at 877-312-144
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or visit bcmwi.com
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we are here to find the best medicare
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coverage for you
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have a great day
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you
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