Insurance Companies Deny New Customers Who Take Certain Drugs

Does the prescription medicines you have taken in the past make for a possible future denial when it comes to getting insurance?
Certain medicines can indeed get you on a blacklist when it comes to insurance.

Those looking for private insurance in Florida are finding that the medicines that they have picked up before at the drug store have made it impossible to get coverage.

Truth Out reports:

“This is absolutely the standard way of doing business,” said Santiago Leon, a health insurance broker in Miami. Being denied for preexisting conditions is well known, but when a person sees the usually confidential list of automatic denials for himself, “that’s a eureka moment. That shows you how harsh the system is.”

Most insurance companies have what they call a guide to Medical Underwriting and often marked “confidential and proprietary.”

One such company is Sunrise-based Vista. Their 35-page guide is hidden inside its website.

“The medical underwriting guidelines used by VISTA are based on industry standards, comply with all regulations and are subject to review by the Florida Department of Insurance. VISTA’s Guide to Medical Underwriting is an educational tool intended to assist agents and brokers who are selling VISTA individual plans. We do not comment on our specific underwriting processes and practices.”

The insurance companies don’t want to take a known risk from the get-go. Certain medications indicate that they will be paying out more than they will be taking in from the very start with a new client.

The guides for Coventry Health Care, which owns Vista; Wellpoint; Assurant Health; and Blue Cross Blue Shield of Nebraska all say those with diabetes, hepatitis C, multiple sclerosis, schizophrenia, quadriplegia, Parkinson’s disease and AIDS/HIV should be rejected.

When it comes to cancer the denial response depends on how long a potential client has been cancer free. For breast and prostate cancer at Wellpoint the remission time has to be over five years. Other types of cancer require a ten year remission period. Assurant Health out of Milwaukee requires all former cancer patients to have been in remission for at least eight years.

Intelliscript and Medpoint do computer searches for all new potential client’s drug use. The companies maintain that they are within privacy laws.

“Ingenix requires each Medpoint client to obtain the authorization of the individual applicant or insured person,” said Ingenix spokeswoman Karin Olson.

Legally companies have to inform you the information that they have in your file.
To ask for your file the Lakeland Ledger gives the following contact information:

Ingenix MedPoint Compliance

Write: 2525 Lake Park Blvd., West Valley City, UT 84120


Milliman Intelliscript

Call: 877-211-4816


Medical Information Bureau

Call: 866-692-6901

Milliman and Medical Information Bureau only have files on persons that have applied for individual coverage.


You must be logged in to post a comment.

%d bloggers like this: