Most people don’t hear much about Medigap underwriting until they try to switch plans, or they apply after their initial enrollment window has closed. That is usually when things start to feel confusing and scary. Suddenly there are health questions to answer, and there’s the possibility of being denied.

Underwriting is simply a review process. But what gets reviewed and how it affects your chances of being approved can depend on different factors. Below, this Supplemental insurance agency in Hebron, Indiana is going to explain how insurance companies determine eligibility during underwriting.

What is Medigap underwriting?

When someone first turns 65 and enrolls in Medicare Part B, they get a six-month Medigap Open Enrollment Period. During this time, insurance companies must accept you regardless of your health. They can’t deny your application or charge you more. This window is your best opportunity to choose any Medigap plan you want.

But outside of that six-month window, insurance companies can ask health questions to evaluate your risk. This review process is called underwriting. And it is how insurance companies decide if you should pay a higher rate or if they should deny your application entirely. Underwriting is also used when you try to switch Medigap plans in the future without a guaranteed-issue right.

There are some exceptions. For example, you could qualify for guaranteed-issue rights if you lose certain types of coverage or your Medicare Advantage plan leaves your service area. But these situations are very rare. For most people applying outside their open enrollment window, complete underwriting should be expected.

What do insurance companies check during underwriting?

When an insurance company reviews your application, it wants to evaluate your overall risk.

The first thing the company will check is your medical history. This includes your past and current illnesses, recent hospital visits, surgeries, chronic conditions, etc. Conditions like heart disease, COPD, cancer, kidney problems, uncontrolled diabetes and recent hospital stays can raise red flags. Insurance companies want to avoid approving someone who could face high medical costs down the road.

Your prescription list is also a factor. A long list of medications can indicate ongoing health issues, even if they are not mentioned elsewhere on the application. Companies can also consider if you have any upcoming procedures or surgeries that could lead to higher claim costs.

Lifestyle factors are important as well. Age is an obvious one. Someone applying at 75 will generally face more scrutiny than someone at 65. Of course, smoking history can result in higher premiums or denial.

Even your location will be a factor. Some areas have higher medical costs than others and insurance companies factor that into their decision-making.

A knowledgeable Supplemental insurance agency in Hebron, Indiana can help you understand what to expect from the process and improve your chances of being approved.

Once the insurance company finishes reviewing your information, it will decide.

The insurance company may approve the application at a standard rate if your health looks stable. It could also approve you but charge a higher premium because it sees you as more likely to have future medical costs.

There are also situations where the company denies the application. This generally happens when someone has certain listed conditions or recent medical events that the company considers too risky.

Keep in mind that being denied by one company does not mean you will be denied by all of them. Underwriting rules can be very different from one insurance company to another. This is why applying with only one company rarely gives you the full picture of your options.

When you work with an experienced Supplemental insurance agency in Hebron, Indiana, you can compare multiple insurance companies at once. An experienced agent can identify which companies are more likely to approve your application based on your medical history.

Looking for a Supplemental insurance agency in Hebron, Indiana?

Would you like some help applying for a Medigap plan? Need help understanding your underwriting options? If so, Senior Care Insurance Services is just a call away.  As the most trusted Supplemental insurance agency in Hebron, Indiana, our licensed agents can guide you through the process from start to finish. Contact us today to get in touch with our team.