Let’s review the general criteria.

There are quite a few factors that determine your insurability and they are always changing depending on how aggressive the health insurance carriers are at gaining market share.

Height/weight: This is the most obvious factor and some carriers are more liberal than others in this department. Currently, Aetna and Cigna have the most liberal stipulations on a person’s build while Humana One, BCBS of Texas and United Health One seem to be the strictest.

Medications: Most insurance carriers have a general guideline that if a person were taking three or more medications to control a single condition, then they would be declined in the private market. This can vary, as the carriers are more forgiving if those medications are generic and thus less expensive than 3 brand name medications.

Medical Conditions: Each insurance carrier publishes an “Agent Underwriting Guidelines” book and those have a list of declinable conditions. While the list is too extensive to mention each condition, some common conditions would be Type I diabetes, invasive cancers which have yet to be eradicated, HIV/Aids and most other auto-immune disorders.

Tobacco use: Smoking and/or chewing tobacco are not an automatic decline, but can be in combination with other medical conditions. A perfect example would be a smoker who also has asthma and uses an inhaler. Any medical condition that tobacco use can exasperate would usually result in a decline.

Pending or very Recent Surgical Procedures: No insurance carrier will write a case on someone if they have a pending surgical procedure yet to be completed. This would be akin to asking your auto insurance company to fix the huge dent in your car that was caused by a recent accident before your policy was in force. Also, if your surgical procedure was less than 3 months ago or you have not have your surgical follow up consultation, the carrier will also decline.

If you’re unsure of your own insurability, please contact  Selected Benefits and we’ll be happy to review your situation and recommend the best course of action.