Underwriting outcome

wilkin

Guru
100+ Post Club
Met with a family this evening and recommended an HSA with American Medical Security. Their teenage son broke his collarbone earlier this summer and is scheduled to have his final follow up visit with the doctor in three weeks and they expect him to be released from care at that point. We were looking at starting coverage on their new plan October 1, but I suggested we wait til November. Do you think we're looking at a rider on the collarbone? If so how long should we wait to avoid a rider?
Thanks.
 
I would do the son on a separate PPO Plan, and just have the parents on the HDHP. The father can still pay for his son's treatments and OOP expenses with the HSA money.

When the son gets a bit older, say in his mid-20's, get him his own HSA, if he wants.
 
For the companies that do waivers it is very likely that they will rider the collarbone area possibly up to a year after the final release visit. So it really doesn't matter if they waiver it now or in 4 months. If they waiver it try to talk them down to 1 year, then apply to have it removed, assuming he had no complications the prior year.

Or you can wait until his final visit in 3 weeks and get a note from the doctor that says he's fine and submit that with the application. Keep in mind even with the release note the underwriter may still waiver it for a year or two.

I'm not familiar with AMS, but I believe that's how they roll!
 
AMS will probably require that he be released from Dr's care. And they will probably rider it, but for only a year (two at the most). Maybe 10 years if the underwriter doesn't like you.

800 232 5432 will have the answer.
 
A simple fracture with no hardware after a release from care:

If that's the scenario in three weeks, call all your carriers and make sure a rider would happen. I'm not so sure. I bet the local Blue has no problem with that. In CT, Golden Rule will usually not rider a simple fracture after its fully healed. Nor would a few other carriers. Hardware/pins etc. is another matter though.

Chumps, GR in PA similar?
 
Thanks to all for your replies. I called AMS this morning and they said if there is a full recovery with no pins or other hardware it would be issued standard without a rider. Great news.
 
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