Did I Handle this Med Supp Issue the Wrong Way?

[wehotex]

I would try to get the sleep study results ASAP and see if you can reverse the decline. A couple of weeks ago I had someone declined by Continental Life because they did not know the results of their most recent PSA blood test. The results were good, but the applicant didn't know the number. The applicant got the latest report, I faxed it to underwriting, and the decline was reversed the next day.

Barring that, I would have the client contact the Part D carrier and cancel the PDP enrollment prior to its taking effect. Doing that should prevent the MAPD plan from being canceled. Then take another shot at this in October instead of February.

Also, and this is very important: do not take a PDP enrollment that will cancel an MAPD until after the med sup is approved in a situation like this.

Yes, thanks. I instructed her to go directly to the Sleep Center to obtain results if her PCP doesn't cooperate. I have the Underwriting fax # and it's ready to go. I've always understood that MA or PDP app can always be rescinded ANY day before the proposed effective date. In hindsight, I can see that doing it your way is better, but we were running short of time and I didn't foresee this happening since she's pretty darn healthy.

 

[WCMason]

Yes, thanks. I instructed her to go directly to the Sleep Center to obtain results if her PCP doesn't cooperate. I have the Underwriting fax # and it's ready to go. I've always understood that MA or PDP app can always be rescinded ANY day before the proposed effective date. In hindsight, I can see that doing it your way is better, but we were running short of time and I didn't foresee this happening since she's pretty darn healthy.

Well, I hope it works out. And if running too close to the 2/14 deadline the way you did it can work if the person really does not want to wait until the next AEP.

 

[goillini52]

I don't recall ever seeing a question on a Medigap app about apnea. FE underwriting is not the same as health insurance (Medigap) and vice versa.

Manhattan Life for the win...5 year look back.

c. Emphysema, Chronic Obstructive Pulmonary Disease (COPD), Sleep Apnea or any Chronic Pulmonary condition?

 

[somarco]

You got me Tom. Appointed with MLIC. Wrote half a dozen apps where someone insisted on the low price. All were T65. Haven't written anything with them in probably a year and no underwritten ones.

Jimmy, you are correct about the pending results question. When faced with an underwritten exam I go over every question in detail and check the med's. Takes a few extra minutes on the front end but spares disappointment (most of the time) on the back end. I hate declines, and rarely have them when the prospect is honest.

 

[bill3173]

You handled it the wrong way. You need to get her back on the Humana gold plan asap, and quit fiddling around with these supp carriers, until the fall.

 

[JimmyUt]

Jimmy, you are correct about the pending results question. When faced with an underwritten exam I go over every question in detail and check the med's. Takes a few extra minutes on the front end but spares disappointment (most of the time) on the back end. I hate declines, and rarely have them when the prospect is honest.

I agree. I have only had one app declined in the last 3 months and that was because of an "internal" height and weight chart. I knew it was iffy anyway, but tried for the client.

 

[somarco]

Speaking of ht & wt, I had a lady declined a few years ago because she wasn't heavy enough. So accustomed to checking wt when they tip 200# that just neglected to look when she told me she 5'0" and 89 pounds. One of the few people I met in person. She was 86 and sharp as a tack. Reminded me of my grandmother and about the same size.

Equitable turned her down because she was a pound under the limit under their catch and release guidelines.

On the other end of the spectrum, I submitted an app to New Era last year on a lady that was 20# over published tables with other carriers. New Era doesn't ask ht & wt on their app so I thought I might be good to go.

Turns out they ask in the underwriting interview.

Approved her any way.

 

[JimmyUt]

On the other end of the spectrum, I submitted an app to New Era last year on a lady that was 20# over published tables with other carriers. New Era doesn't ask ht & wt on their app so I thought I might be good to go.

Turns out they ask in the underwriting interview.

Approved her any way.

I have found them to be the most predictable company I have when it comes to U/W

 

[paul43]

When I went for my sleep study I had results the next day, Can she still be waiting for results?

When I went for my Sleep Apnea test I asked technican how I did. He said no problems--slept like a baby. I think he put something in my 3 beers before I took the test.
Paul43

 

[Chazm]

Speaking of ht & wt, I had a lady declined a few years ago because she wasn't heavy enough. So accustomed to checking wt when they tip 200# that just neglected to look when she told me she 5'0" and 89 pounds. One of the few people I met in person. She was 86 and sharp as a tack. Reminded me of my grandmother and about the same size. Equitable turned her down because she was a pound under the limit under their catch and release guidelines. On the other end of the spectrum, I submitted an app to New Era last year on a lady that was 20# over published tables with other carriers. New Era doesn't ask ht & wt on their app so I thought I might be good to go. Turns out they ask in the underwriting interview. Approved her any way.

Couldn't tell her to just go buy 4 quarter pounders at McDonalds and call it a day? )