New Era Joint Replacement a Decline?

[Chazm]

Forgive me for my ignorance, I pretty much stick with UHC in FL but every now and then I do a med supp out of state.

I have a client who had bypass surgery 7 years ago and found that New Era would take her because it's outside of 5 years. Well as I was going through the application with her just now, I got to question 5. In the past 12 months have you had placement of a pacemaker or had a joint replacement?

She had a half a knee replacement in December and it was an outpatient procedure. Is that really a decline? On CSG they don't even have that as an option for a decline.

This is in GA.

 

[senior-advisor-indiana]

Forgive me for my ignorance, I pretty much stick with UHC in FL but every now and then I do a med supp out of state.

I have a client who had bypass surgery 7 years ago and found that New Era would take her because it's outside of 5 years. Well as I was going through the application with her just now, I got to question 5. In the past 12 months have you had placement of a pacemaker or had a joint replacement?

She had a half a knee replacement in December and it was an outpatient procedure. Is that really a decline? On CSG they don't even have that as an option for a decline.

This is in GA.

They are the only company I know of that asks that and yes it is a decline...

 

[vic120]

What SAI said and Also I have learned not to lean on CSG for underwriting.

As I do work over the phone I have PDF of Most companies Medical questions for quick access, Get familiar with them Also have some notes for some special situations like Equitable will take cancer free and heart attack with only 2 year look back.

A lot of things will take some time and experience and Goillini is always putting a lot of great underwriting info on different threads which has helped me tremendously

 

[goillini52]

Forgive me for my ignorance, I pretty much stick with UHC in FL but every now and then I do a med supp out of state.

I have a client who had bypass surgery 7 years ago and found that New Era would take her because it's outside of 5 years. Well as I was going through the application with her just now, I got to question 5. In the past 12 months have you had placement of a pacemaker or had a joint replacement?

She had a half a knee replacement in December and it was an outpatient procedure. Is that really a decline? On CSG they don't even have that as an option for a decline.

This is in GA.

That would be a decline. It also says it in their UW Guide.

I don't think I've ever heard of half of a knee replacement.


Most companies only go back 2 or 3 years on a bypass, and many don't ask about a joint replacement except are they having surgery or been recommended to have surgery. As long as she's done with treatment/therapy, I don't see that as a hard case to place.

Ditto on the UW on CSG, it's so inaccurate that I don't even look at it.

 

[Chazm]

Thanks guys. Not sure why I was thinking they would be the only company to approve her with the bypass but I just realized she can pay just a little more and get CSI or Cigna as well.

Anyone have a idea of how long Cigna usually takes to approve underwritten apps?

 

[Todd King]

Thanks guys. Not sure why I was thinking they would be the only company to approve her with the bypass but I just realized she can pay just a little more and get CSI or Cigna as well.

Anyone have a idea of how long Cigna usually takes to approve underwritten apps?

From my understanding they are decently quick. Middle of the pack.