Help

[scottfanli]

hey guys,
I have a buddy of mine in the state of PA who currently pays 174 dollars a month for HMO health insurance. He is 20 years old 5'9 195 non smoker full time college student. He wants me to find him a cheaper plan but he was diagnosed with tuberculosis and he says he has the latent form and not the serious form(does it make a difference?). He currently takes prescription meds for it so he would need it when he switches. I have filled out a prescreen for aetna and united and they both said they wouldn't be able to cover it if he switched. Does this sound normal? i thought things like tuberculosis isn't that big of a deal? does anyone know of any carriers that would accept him in PA? what should i do?

And a side question since he was on an HMO plan, does that mean when and if he gets on a new individual plan he would have to go to the doctor again and get lab tested(which is very expensive deductible plus coinsurance) to get the prescription or could he still continue getting the prescription meds without doing anything?
what would he have to do when switching or in other words what is the whole process like when switching health insurance plan for everything to go back to normal?

thanks

 

[somarco]

Pre-screen's and applications are only as good as the information provided. Did you tell them he has the latent form? Did you indicate the meds including dosage?

In this case it probably would not have mattered. Even latent TB can eventually develop into an active case.

Most agents don't use pre-screen and many that do don't understand how to use this tool properly. Probably 10% of my prospects end up going thru a pre-screen process. Most of the time the final results match the pre-screen.

An effective pre-screen saves a lot of time and builds credibility with your client and with the carrier.