How Often Do Insurers Change Their RX Guides and how Important is the "RX Fill Within" Section?

[VolAgent]

Thanks! So it's safe to say the underwriters take this portion very seriously? Which would mean, in order for me to know what plan someone will qualify for, it's in my best interest to look at the dates on the bottles and take note?

I'm still a little confused about the insurers with less-detailed RX guides. I don't like the idea of leaving whether or not an application will be approved up to chance. Especially if these insurers _are taking_ certain unlisted prescriptions into account and they're just not telling producers about it.

Other than the fact that yes, they take it very serious, you are over thinking this.

Simply ask them what they take and why and when they started. The cases where someone is right on the edge of the "fill within" date are the exception and not the rule. Most people will be safely within or outside that period.

 

[donamese]

Thanks! So it's safe to say the underwriters take this portion very seriously? Which would mean, in order for me to know what plan someone will qualify for, it's in my best interest to look at the dates on the bottles and take note?

I'm still a little confused about the insurers with less-detailed RX guides. I don't like the idea of leaving whether or not an application will be approved up to chance. Especially if these insurers _are taking_ certain unlisted prescriptions into account and they're just not telling producers about it.

Medications are complex, one medication can be used for a declinable condition but also used for a condition that is ok. Your best bet if it really worries you, is to work with carriers that have a true POS, not a Foresters type that gives a general approval then sends it to underwriting to determine what level they qualify for.

 

[Baseball7]

Forresters doesn't do any underwriting in house for plan right. Not sure what you're talking about unless you have a specific example when they overturn the case after Appitical approved it.

 

[donamese]

That is basically what I was getting at. The approval comes through but doesn't state immediate/graded/modified. So while you think it is immediate, it can come back as graded or modified.

 

[Baseball7]

You're 100% off base...
" The proposed insured is qualified to apply for the level death benefit"

Or if it's graded, modified, or declined they will tell you and tell you why.

What are you even talking about?

 

[VolAgent]

That is basically what I was getting at. The approval comes through but doesn't state immediate/graded/modified. So while you think it is immediate, it can come back as graded or modified.

While there are some companies like that, Foresters is not one of them. What Apptical says is what it is.

Now, I have gotten them overruled with documentation, but Apptical gives you a firm answer.