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- #11
Breast Cancer / Tamoxifen Type Drugs
- Thread starter Cyborg7
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Trinity/Family Benefit, no problem.
- 19,638
The answer on the interview is a done deal.
I sent an email to the head underwriter at RNA a month or so ago and copied my field contact and an operations manager about this very subject. We were hearing that some were getting declined for meds not on the list.
The answer I got back was they had made some changes but the changes were to remove meds from the knockout list, not add any.
Foresters will do it Level if first fill was greater than 3 years ago.
- 17,069
I had a single pay case recently. This was the exact med that was the problem. I wasn't sure how they underwrote on single pays because I had never used RNA for one.
They told me their single pay has underwriting just like their SIWL. But that even though this med is not on their knock out list they consider it as treatment for cancer the whole time they take it.
One of my regular single pay companies is Oxford. But it's a knock out for them.
Next I call Lafayette. They will take it at table 2. But the case was too small to use them.
So I went to Settlers which I just assumed wouldn't take it. They were very familiar with the med and have no problem with it as long as the caber treatment was 2-years or more away.
Believe it or not, the case was too large for their Silver plan. But they made an exception for me and took the case. Another happy ending.
- 19,638
Same thing with that drug. I've had several approved level with RNA. That med is not on their list.
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- #17
- 17,069
I've had one. But it was back when they were still using their paper app.
$3,000 case of all things on a 81-year old lady with a whole shoe box full of meds. They give us the approval. I help her cancel her Columbian.
About an hour later I get the phone call. They made a mistake. They can't take her. I let them know that it's a HUGE problem since she canceled her other policy. Deaf ears.
I get Travis involved. They call me back, apologize, and promise that it will never happen again.
- 19,638
I believe you and I think your situation was what prompted my email to RNA. Yours and I believe Joe had one like that?
They told me that was not the case and you know because you were copied on my original email to RNA and on the answer.
As was Travis. He couldn't understand why I even sent the email since he had never had that problem nor had he heard of others having that problem.
RNA has always been my most predictable company. They have never once declined or changed one to graded on a med not on their list. Not one time!
Travis says the same. Now, if a med is on their list and one uses then then anyway, they will have a problem. Every time!
I don't use them much anymore because of the insane voice sig app and mostly because of the 2013 rat increase. But for doing what they say they will do? I've never used a company better.
JD, RNA declined me on a case for Letrozole about 3 months ago. They shut down as soon as i finished giving them her prescriptions and told me it would be a decline. They said Letrozole was a knockout but was not on the list. Trinity took the case with no problem.
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I didn't fight them on it. I don't fight carriers on declines or uprates. I just move on to another carrier.
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