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When buying health insurance, let your agent help decide what in your health history is relevant.

06-29-2009 by Colleen King

Health insurance remains one of those things that most people still find confusing. For group health insurance, disclosing your health history helps determine the rates your employer gets. For individual health insurance, it determines not only rates, but whether or not you will even be accepted!




Focusing on individual health insurance, all carriers ask about whether you’ve taken medication, been treated for or had symptoms of anything in the past  ten years. One carrier, it used to be the past twenty years. There’s a rumor that one is going to drop it to the past five years. Whatever the number, talk to your insurance agent about anything you’ve been treated for, because carriers look at things differently than you and I do. I recently did a policy with a nice guy who was on no medication, not under the care of a doctor or anything. When I saw his online application though, he had stopped taking an antidepressant 3 months ago.  He did end up getting approved but at an above standard rate because of this. Why does it matter? He isn’t on anything! This is one of those cases where depending on the carrier, an applicant needed to be off medications between 6-12 months in order to qualify for a standard rate. Recently stopping some medications, they are concerned that you haven’t been off of it long enough and may need to go back on it. Basically, don’t let common sense and logic get in the way of reality.


Another dicey situation is when women have had breast implants. Now, consider this. When you first start working with a health insurance agent, it’s not unusual for them to be someone you found on the internet, pretty much a total stranger. They are going to be asking all sorts of personal questions, and you don’t know them from adam. Women often think they don’t need to disclose their implants, after all, it was cosmetic and insurance didn’t cover them before, so what does it matter? Well, it does. Some carriers, silicone implants are an automatic decline. Others, depending on how long ago they were inserted, will accept you but at an above standard rate because of the high likelihood of someone developing contractures, encapsulation that hardens and causes pain necessitating removal. And the carrier may be on the hook for it. I finally figured out a less direct, more tactful way of asking the question so I run into that ‘surprise’ less often.


I could go on, but I think you get the idea. Even if you think an old health issue is irrelevant, talk to your insurance agent about it when considering making a change. If you don’t disclose and there’s an issue down the line, your policy could be rescinded and new coverage tough to obtain. And if you aren’t comfortable with the agent you are talking to, talk so another one or two. There are tons of us out there, we all want your business but you’re the consumer, so find someone you like dealing with!


Be well!



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