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Medical Underwriting – Health Insurance Underwriting

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Medical underwriting is simply the process whereby an insurance carrier examines the medical history of a prospective client with the view of deciding what can be contained in their health insurance coverage and for what cost.  It is crucial for someone considering health insurance options to research medical underwriting and follow steps to lower their prospective health insurance costs.

The two ways in which an insurance providers assess applications for coverage are known as moratorium underwriting and full medical underwriting. Like anything else when you have a choice both have their advantages and disadvantages and depending on the specific needs of a client he may decide that one suits him more than the other.

Moratorium underwriting

When undertaking moratorium underwriting only three or four questions are asked about the client’s medical history. These can be as straightforward as, “Have you been to a doctor in a certain period?” Normally if you can state that you have been free of being given treatment and advice for a medical condition for a given period before the policy starts, you’ll receive coverage for it.

The main upside of moratorium underwriting is that there is no need to fill in a detailed health assessment questionnaire, and any pre-existing conditions for which you have received treatment or advice are automatically excluded although cover for these conditions can be reinstated after two continuous years from the start of the policy, should you remain symptom, treatment and advice-free in that time.

Another positive aspect of a moratorium underwriting is that it is fast to implement.  However, the main disadvantage is that the policyholder will continue to be underwritten every time they make a new claim.

The main purpose of any type of health insurance is to provide the insured peace of mind, allowing him or her to sleep easier knowing that they have done everything required of them at the time of purchase. Health insurance companies like to assure customers that if they require treatment, their insurance is ready to take care of it promptly and without raising any issue.

Full medical underwriting

Full medical underwriting may be the preferable option in for many people as, in this case, the insurance provider asks a number of detailed questions about the customer’s medical history at the time of your application. However, this process can take some time, averaging about a week in order that all information and files are gathered. They are then in a position to decide on what will and won’t be covered on the health insurance policy.  As you might have guessed, full medical underwriting may be preferable for those in good health and with good medical histories.

The upside of full medical underwriting is that you know exactly what you are and are not covered for. This, once again, helps with the “peace of mind” of anyone who has gone to the trouble of buying an insurance policy.

Full medical underwriting is not entirely free of problems. Just as the name suggests, it is comprehensive and for this reason it takes longer to create a working policy. It also means that the underwriter will want to know lots of intimate details about the applicants.

Full medical underwriting can be advantageous as well as being disadvantageous. It is important that everyone looking for the best health insurance plan carefully read the conditions of each plan they are offered, and be assured that they have found the best option that suits their own situation.

What Does My Health Insurance Cover?

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In the UK alone, around 7 million people are covered by health insurance.  Even more so are covered in the United States.  Most of these people are covered by their company.  However, very few of these people have actually reviewed their policy and understand what is or is not covered.

If you think that health insurance pays for all health costs, you’re mistaken.  Health insurance usually only provides protection for short-term and curable health problems.  Usually, health insurance allows you to see consultants, doctors, get surgery, or be treated.  However, before you buy a health insurance plan you need to research the health bills that are not covered by your health insurance plan.

This article does not relate to any specific policy and individual health insurance plans are different.  That’s why you should be sure to check your policy documents.  After reading this article, you’ll know what to be on the lookout for!

Chronic conditions

If a condition is curable and is not a long-term problem, insurance companies classify it as “acute” and usually cover such problems.  However, if a problem is not curable or will require long-term treatment, then it is classified as “chronic”, and you usually won’t be covered.  Drawing a fine line between “acute” and “chronic” usually leads to difficulties between the insurance company and the policy holder.

It is agreed that problems such as diabetes and asthma are chronic conditions, since they likely last for your entire life; therefore, these are not covered by insurance.  However, when a doctor considers one’s illness to be curable but it quickly deteriorates and it becomes incurable, it is defined by insurance companies as chronic, as it has become chronic during treatment.  These problems usually arise in different stages of cancer.

Long-term conditions

Insurance companies usually do not pay for long-term treatments.  Be sure to check your policy information to see how your insurance provider defines a long-term condition.  Many times, if use of a single drug extends for a year or so, the insurer will only pay for the first ten months.

Preventative bills

Most insurance plans only pay for the treatment and cure of conditions after the arise, not for treatments that may prevent a sickness.  once again, how your insurance provider defines this can cause problems.  For example, the drug Herceptin can be considered as a cure or preventative.  Herceptin is used in the early stages of breast cancer, and can halve the chance of cancer returning for woman.  However, it can be considered as a cure or preventative.  Insurance companies and policy-holders can have problems in such a case.

Hopefully, this article has been helpful to reviewing your health insurance plan.  Always contact your insurer when you have any doubt about whether your medical bill is covered.