Which Texas Med Supp for a Rheumatoid Arthritis prospect?

[wehotex]

AETNA seemed to be the toughest one yet. They don’t want if diagnosed with this. CIGNA CHLIC seems to accept it, but only if it does not affect ADL. If it’s a STRICT definition of lack of ADLs, I don’t think that it applies to her. Meaning that she IS in pain, but still gets along ok.

 

[kstein]

Just had this same thing in Illinois. Aetnas app has no RA questions that I saw.

 

[wehotex]

Just had this same thing in Illinois. Aetnas app has no RA questions that I saw.

Texas AETNA app asks for “Arthritis that limits mobility or ADLs”

Did a second look- CIGNA is the one that asks if “During the past 2 years, if treated for “rheumatoid arthritis” or “disabling arthritis”.” This would seem to exclude any and all RA patients.

 

[goillini52]

AETNA seemed to be the toughest one yet. They don’t want if diagnosed with this. CIGNA CHLIC seems to accept it, but only if it does not affect ADL. If it’s a STRICT definition of lack of ADLs, I don’t think that it applies to her. Meaning that she IS in pain, but still gets along ok.

Rheumatoid Arthritis: Atlantic Coast Life/SentinelSecurity(Over 2 years unless treated with injections or Methotrexate and Prednisone of more than 25 MG of Methotrexate per week, then it’s a decline), Bankers Fidelity(Individual consideration), Everest(Over 2 years and no events, complications or injections), LBL(Over 2 years no change in treatment & no increase in dosage of meds in past 2 years)

 

[kgmom219]

What are the meds and issues?

 

[Thomas Mead]

I just had a client try to go from Physicians Mutual to Aetna and got declined because of an RA med. MOO is tough too. A strategy I was told was to put them in an Advantage plan for a few months (since he had never been in one) and then switch back triggering an SEP that allows him to go back to the same plan with his choice of carriers. It seemed greasy so I left him where he was, but maybe someone can weigh in on this.

 

[Thomas Mead]

Aetna and MOO will decline a Humira applicant.

 

[goillini52]

I just had a client try to go from Physicians Mutual to Aetna and got declined because of an RA med. MOO is tough too. A strategy I was told was to put them in an Advantage plan for a few months (since he had never been in one) and then switch back triggering an SEP that allows him to go back to the same plan with his choice of carriers. It seemed greasy so I left him where he was, but maybe someone can weigh in on this.

You're talking about a "Trial Right". They'd have to go back to PMIC as long as they still offered the same plan, so nothing gained.

I'm not aware of a company that wouldn't make them "go back to where they came from".

 

[Millwood]

You're talking about a "Trial Right". They'd have to go back to PMIC as long as they still offered the same plan, so nothing gained.

I'm not aware of a company that wouldn't make them "go back to where they came from".

I've as always been told they have to go back to prior Med Supp only if that block of business is still open. I know from experience this is true with Aetna. Usually no commision involved since its GI.

 

[vic120]

I've as always been told they have to go back to prior Med Supp only if that block of business is still open. I know from experience this is true with Aetna. Usually no commision involved since its GI.

This is correct if the previous company is not available they can choose a new one for GI