Metabolic Syndrome

[bluemarlin08]

Have a lady, 56, one BP med, one chol med, doc records diagnose metabolic syndrome ( pre type 2 diabetes) denied by BC, GR and Humana, any suggestions? Very important case.

 

[Todd King]

You might try Assurant.

 

[souldeux]

Three denials? Ouch - prescreens are important.

I think you have the slimmest of outside shots with Aetna, and you miiiiiiiiiiiight squeak out a ridiculous rating with Assurant, but they're both going to give you absolute hell.

 

[dgoldenz]

Does BC/BS offer a GI plan with a 12-month wait on pre-ex in your state? I know they do in VA, not sure about other states. Runs about $800/month, but the benefits are decent for someone who can't get any other coverage.

 

[bluemarlin08]

She has coverage on husband's plan, Orthodontics Association, really expensive, paying 16k per year with a 21% rate increase. Applicant didn't disclose everything up front. Just got my foot in the door and was hoping I could be the white knight, but alas.

 

[TXINSURANCE]

I am curious do you sell a lot of individual health insurance?

Syndrome anything - 99% likely to not issue.

The HBP / CHOL alone is not good, and their DIABETES (sorry to call it what it is) is a knock out. Applicant not disclosing everything upfront is when I politely bow out (what else are they leaving out?).

What state is this?

p.s. nothing wrong with trying pre screens, you never know.. I wouldn't actually apply this case though IMHO.

 

[bluemarlin08]

I am curious do you sell a lot of individual health insurance?

Yes I do, what is your point? Client didn't disclose, how would you have handled this? Pre screens are irrelevant without disclosure.
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BTW, only denied officially by one company, prescreened the others.

 

[somarco]

What is her BMI?

 

[bluemarlin08]

5'11 160lb, let me know if you have any ideas.

 

[souldeux]

She has coverage on husband's plan, Orthodontics Association, really expensive, paying 16k per year with a 21% rate increase. Applicant didn't disclose everything up front. Just got my foot in the door and was hoping I could be the white knight, but alas.

I'd walk away. There are lots of people out there who want health insurance - your time is better served finding and helping them. I can't stand working with a dishonest client, because when they try to "put one over on the system" they end up screwing themselves and you in the process.