I have a Life Client who has asked me if I can help her to get some Health Insurance. Let me start off by saying that I have been away from the Health Insurance arena for a couple of years...(I used to sell MEGA a few years back - which was a terrible experience - and after I escaped from them, I decided to go independent and concentrate on Life & Annuities)......however, I did try to do a little checking around and the underwriting depts. of both Anthem/BCBS and Aetna said that if she applied, she would probably be declined b/c of her weight.
She is 44 years old; she weighs 307; she is 5'9, and she has sleep apnea. She has no other health conditions and takes no meds. A paramed, APS and EKG was done for the Life application, and everything came back fine. The sleep apena is treated with a CPAP machine. She lives in Virginia.
Do any of you Health Agents have any suggestions as to what I can recommend that she do about Health Insurance ??? I was actually able to get her approved for a Life policy (rated up of course) with about 3 different carriers; so I was thinking that "maybe" there are some Health companies out there that would approve her as well.
Any recommendations or suggestions would be greatly appreciated.
(P.S....I've already given her one good suggestion: looseweight soon !)
She is 44 years old; she weighs 307; she is 5'9, and she has sleep apnea. She has no other health conditions and takes no meds. A paramed, APS and EKG was done for the Life application, and everything came back fine. The sleep apena is treated with a CPAP machine. She lives in Virginia.
Is this a joke???
5'9 307lbs and sleep apnea. Her best option with her current health is a Group plan from her employer, State Risk Pool which isn't offered here in VA or a prayer. She'll have to lose weight before any individual health carrier will even consider her sleep apnea.
I'm 6'7" and weigh the same and I have a BMI of 35. You have a life company that will write her? wow. She's gotta have a BMI of 45+ (actually 45.3) That impressive that she can even entertain a life policy.
It sounds like you have no state pool which is too bad. I don't think outside of being in a group plan you'll have much luck.
She is a time bomb health wise, give her a few more years at that weight... what life company did you use.
Ok, here is one idea for you. Although she would be declined by almost all carriers, (I do have one carrier who would go to 296 lbs at her height), there is a plan on the market she would qualify for:
This plan asks NO health questions. It is a HIPPA compliant plan and does have limited benefits.
This plan would NOT pay for any pre-existing for (12) months unless she had a Certificate of Credible Coverage from a qualified group. HOWEVER it would issue her a CCC after she had been on the plan for (12) month which could be a boon for her.
I don't see why she could not get a HIPPA plan from Anthem in VA? I believe the differential is 400%.
This person has VERY SERIOUS medical condition of obesity and sleep apnea, that is nothing to mess around with. Even at 400% rate up, the carrier is likely still subsidizing her risk level.
Unless she is not HIPPA compliant then we go back to the issue of personal responsibility - she allowed herself to have a gap in coverage for whatever reason.
You failed to leave out when was the last time this person had creditable coverage? I can take a wild guess here - but I might be wrong.
I was able to get 200K approved for her with Life of the Southwest (w/a 300% rate up).
You failed to say when was the last time this person had credible coverage?
She said that she had coverage thru COBRA after leaving her last employer in October. She said it was sooo expensive for her and her three kids that she just could not maintain the premiums anymore so she stopped paying the premiums in February.
Yea.....I don't think she consulted anyone about it, and I've only known her for about 5-weeks. I think she just got overwhelmed with the cost of COBRA and let it lapse. She has obtained health coverage for the kids since then......so I was just making an effort to try and see if there was "anything" I could do to help her get something for herself since she has become a life (insurance) client for me. Unfortunately, there are times when you just aren't able to help your clients with all of there needs as you would like to.
And unfortunately, Virginia does not offer a guaranteed issue health product (that I am aware of).
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