Declined for Strep Throat. WTF?

Golddoor · 07-24-2007, 05:52 PM

I had Unicare decline a 21 year non smoking healthy woman for having strep a month before submitting an app. WTF? Are they kidding? She was young and healthy to, with no other health issues what so ever.

My declines are starting to over ride my approvals and I cant figure out why? It seems like every single person or family I get an app ,they request an APS and then decline or rate up. Im working internet leads and my own telemarketed leads to business owners. It doesnt matter young or old, rich or poor, they all have health issues that Im dealing with. Im doing the work to get the leads, then to having to deal with this BS is making me think about going into another line of work!!

K-Dub · 07-24-2007, 06:03 PM

If an APS was pulled and the doctors records say she needs to come back in for a follow up that could do it. I'm not familiar with Unicare and how they underwrite though.

How do you know if was for strep? Are you guessing that was why or is that what the letter sent to your client said? Maybe there is something she isn't telling you? Oh wait, clients don't lie....what was I thinking?

Golddoor · 07-24-2007, 06:11 PM

Quote:

Originally Posted by K-Dub

If an APS was pulled and the doctors records say she needs to come back in for a follow up that could do it. I'm not familiar with Unicare and how they underwrite though.

How do you know if was for strep? Are you guessing that was why or is that what the letter sent to your client said? Maybe there is something she isn't telling you? Oh wait, clients don't lie....what was I thinking?

No I actually had Unicare tell me why they declined. They said in 2 months she would qualify as long as she didnt have any thing new. They said that was all that declined her was the strep!

07-24-2007, 07:02 PM

I asked the wife bout this one...(She's in her final year of med school)

There is a slight chance with strep throat that the bacteria from strep throat could go to your heart and effect your heart. There is also a slight chance that it can effect your kidneys...

Both of these are possible only if it's not treated though.

A lot of times it will be 4-6 weeks till the person experiences symptoms.

Perhaps this is why they declined and said they would issue in 2 months? Hope that helps somewhat....

What a silly reason to decline though. A 21 year old healthy non smoker... I would assume this is an ideal person for the insurance companies to insure!

Golddoor · 07-24-2007, 07:19 PM

Quote:

Originally Posted by nate124

I asked the wife bout this one...(She's in her final year of med school)

There is a slight chance with strep throat that the bacteria from strep throat could go to your heart and effect your heart. There is also a slight chance that it can effect your kidneys...

Both of these are possible only if it's not treated though.

A lot of times it will be 4-6 weeks till the person experiences symptoms.

Perhaps this is why they declined and said they would issue in 2 months? Hope that helps somewhat....

What a silly reason to decline though. A 21 year old healthy non smoker... I would assume this is an ideal person for the insurance companies to insure!

Yea thats kind of what I got from Unicare. "Could lead to other issues". So if you just had the flu would you get declined? Im sure that with your immune system down while fighting the flu could also lead to other problems also.

07-24-2007, 07:28 PM

Quote:

Originally Posted by Golddoor

Yea thats kind of what I got from Unicare. "Could lead to other issues". So if you just had the flu would you get declined? Im sure that with your immune system down while fighting the flu could also lead to other problems also.

No kidding.... you can argue that about a million different things! I don't sell Unicare, so I'm unaware of their underwriting guidelines... but this seems excessive for sure.

Can you place her with another company??

Golddoor · 07-24-2007, 08:08 PM

Quote:

Originally Posted by nate124

No kidding.... you can argue that about a million different things! I don't sell Unicare, so I'm unaware of their underwriting guidelines... but this seems excessive for sure.

Can you place her with another company??

Unicare told me they would approve a short term plan for her for now. Im going to check underwriting with some other companies and see if every one else is the same with their underwriting!

*STIBROKER@AUSTIN.RR.COM* · 07-24-2007, 08:44 PM

Quote:

Originally Posted by Golddoor

Unicare told me they would approve a short term plan for her for now. Im going to check underwriting with some other companies and see if every one else is the same with their underwriting!

Dude....take her to Aetna....after one year and the big increase take her back to unicare.....

BKrocko · 07-24-2007, 08:55 PM

LOL, hey Chris, what did you do - piss off some underwriter? Man I feel for you. Some of the stuff you run into gets pretty wild, and it sure sounds like you are doing all of the right things. Keep your head up and everything will eventually go your way.

I know that you have come a long way since last year when you started and that is very admirable - so don't think about quitting now, just keep on truckin'.

Does Unicare have pre screen available? Unless the person I submit is super clean health wise, I almost always run it by pre screen first (enough that I am a pain in their arse). CO does not have Unicare though.

- Barry

Golddoor · 07-24-2007, 09:34 PM

Quote:

Originally Posted by STIBROKER@AUSTIN.RR.COM

dude....take her to Aetna....after one year and the big increase take her back to unicare.....

Dude,

Thats the plan, but Im not sure about if she will make it back to Unicare? She might catch a cold in the next year and get declined again!

Quote:

Originally Posted by BKrocko

LOL, hey Chris, what did you do - piss off some underwriter? Man I feel for you. Some of the stuff you run into gets pretty wild, and it sure sounds like you are doing all of the right things. Keep your head up and everything will eventually go your way.

I know that you have come a long way since last year when you started and that is very admirable - so don't think about quitting now, just keep on truckin'.

Does Unicare have pre screen available? Unless the person I submit is super clean health wise, I almost always run it by pre screen first (enough that I am a pain in their arse). CO does not have Unicare though.

- Barry

I dont think I have pissed off any underwriters but you would think I have with every thing thats going on with me lately!! LOL

I guess Im going to have to ask every one of they had a cold this year before submitting an application.

policy doctor · 07-24-2007, 11:00 PM

It's almost like the industry is begging for universal healthcare by declining most applicants.

Just heard on radio yesterday a John Hopkins study that says obesity will be 60% of our population by yr 2015. They keep talking about fat kids while they feed them liquid cheese/corndogs/pizza in schools.

BKrocko · 07-24-2007, 11:58 PM

Quote:

Originally Posted by policy doctor

It's almost like the industry is begging for universal healthcare by declining most applicants.

Just heard on radio yesterday a John Hopkins study that says obesity will be 60% of our population by yr 2015. They keep talking about fat kids while they feed them liquid cheese/corndogs/pizza in schools.

That's because by 2015 we don't want Baseball to be our National Past Time - Get ready for Sumo Wrestling!!

K-Dub · 07-25-2007, 12:30 PM

Quote:

Originally Posted by Golddoor

I guess Im going to have to ask every one of they had a cold this year before submitting an application.

I hear that they are planning on adding a question to the application that states, "Have you ever thought about visiting a doctor anytime in the past 5 years?" Below that will read, "If so when and why?" Any "yes" answer is an auto decline!

Good luck with that!

*STIBROKER@AUSTIN.RR.COM* · 07-25-2007, 01:30 PM

Quote:

Originally Posted by Golddoor

Thats the plan, but Im not sure about if she will make it back to Unicare? She might catch a cold in the next year and get declined again!

Now how do you know that the doctors did not write in her records that she might also need her tonsils removed in the near future.....I had a guy get a GB waiver one time and he thought the insurance company was crazy because his doctor never said anything about his GB.....turns out in his MR the doctor noted that he thinks he might have a polyp on his GB.....and never told his patient....

Golddoor · 07-25-2007, 06:24 PM

Quote:

Originally Posted by STIBROKER@AUSTIN.RR.COM

now how do you know that the doctors did not write in her records that she might also need her tonsils removed in the near future.....I had a guy get a GB waiver one time and he thought the insurance company was crazy because his doctor never said anything about his GB.....turns out in his MR the doctor noted that he thinks he might have a polyp on his GB.....and never told his patient....

"Never told his patient"

I think I would be finding another Doctor for starters then possibly talking to a malpractice attorney after that if I were that Guy.

healthagent · 07-25-2007, 06:44 PM

Don't worry - we all deal with the BS. I have an Assurant client who's been on the books going on three years so we discussed options. I recommended the GR HSA - he's slighly overweight, 5 pounds over standard on HBP well controlled one med 10mg dosage.

Called GR pre-screen: NOT A PROBLEM AT ALL - ESPECIALLY ON A HIGH DEDUCTIBLE PLAN! SUBMIT IT!!! It took GR just over a week to flat decline it - let me know by shooting out a letter and a day following had the gall to mail the policy just for his wife!!!! Thank's GR!!!

Of course, I told GR to ram up where the sun don't shine, kill the policy just for the wife and now we're off to a Aetna which I should have recommended at the get-go. Declined for 5 pounds over standard - still WELL within the guidelines and HBP on a HSA? GR has lost their minds. ANY other carriers takes that deal in a day. Lesson again learned.