High Blood Pressure and Health Insurance Underwriting

Hypertension is an intermittent or sustained elevation of diastolic or systolic blood pressure. If left untreated hypertension can attribute directly as major predicator of stroke, cardiac disease, and renal failure. Complications occur late in the disease and can attack any susceptible organ system. Cardiac complications include coronary artery disease, angina, myocardial infarction, heart failure, arrhythmias, and sudden death. Neurologic complications include cerebral infarctions and hypertensive encephalopathy. Hypertensive retinopathy can cause blindness. Renovascular hypertension can lead to renal failure. There are basically three separate classifications utilized to categorize prognosis.


The Three Phases of Blood Pressure Readings,

(1) Pre-hypertension is classified as systolic blood pressure greater than 120 but less than 140 mm Hg or diastolic blood pressure greater than 80 but less than 90 mm Hg.

(2) Stage 1 Hypertension is classified as systolic blood pressure greater than 139 but less than 160 mm Hg or diastolic blood pressure greater than 89 but less than 100 mm Hg.

(3) Stage 2 Hypertension is classified as systolic blood pressure greater than 159 mm Hg or diastolic blood pressure greater than 99 mm Hg.

What Underwriters are concerned with.

The cause of essential hypertension is unknown. Family history, race, stress, obesity, a diet high in sodium or saturated fat, tobacco, hormonal contraceptives, excess alcohol intake, sedentary lifestyle, and aging have all been studied extensively to determine their role in the progressive development of hypertension.

Because of the multitude of co-morbidities which are prevalent during progression of a hypertensive condition, insurers are hesitant to issue a policy on a proposed applicant. This article was intended to assist applicants diagnosed with hypertension or high blood pressure in obtaining a approval for a health insurance policy in the individual private healthcare marketplace at standard rates.

Although essential hypertension has no cure, drug therapy and diet or lifestyle modification can systematically control it. Generally, nondrug treatment is attempted first, especially in early mild cases. If this proves ineffective, treatment progresses to include various types of antihypertensive measures. Treatment for a patient with secondary hypertension includes correcting the underlying origin and stabilizing hypertensive effects. Severely elevated blood pressure or a hypertensive crisis may be refractory to medications and may be fatal.

Health insurance underwriters are essentially concerned with the intermittent stages of a progressive hypertensive condition and consequently interrogate an applicant to determine propensity for his or her risk. The following are questions commonly asked during the underwriting screening and useful tips for proper preparation.

Health Insurance Underwriting Questions and Tips.

(1) Does the applicant smoke?

Tip: Habitual smokers who are hypertensive are often insurable. However, smoking only adds cumulatively to the potential negative prognosis of hypertension even if systolic and diastolic pressures are under control. Consider eliminating cigarettes or tobacco prior to application submission. If a paramedical examination is requested a urinalyses can only detect presence of nicotine for three days after ingestion or consumption. The body metabolizes or breaks nicotine levels down within 72 hours. Life insurance policies have a 2 year contestability period to contest the validity of a claim upon death and may find out about the smoking, however for health insurance companies underwriting a hypertensive case, this transparent difference in smoking or not smoking can be a matter of eligibility to be covered if at all.

(2) When was the applicant diagnosed with hypertension?

Tip: Hypertension that is not well controlled meaning a reading that is greater than 140/90 with one or both numbers is a lethal condition. It can lead to heart attack, stroke, and kidney failure. The longer an applicant has hypertension that is poorly controlled, the greater possibility of a target organ being affected such as heart, brain, kidneys, or liver damage. Knowledge of when the applicant was initially diagnosed with hypertension is the first stage of the risk assessment process. If the diagnosis dates back several years the underwriter might request an attending physician statement from the general practitioner. If documentation is readily available demonstrating the previous three visits show blood pressure to be controlled then providing this information during application submission will aid tremendously not only in reference to approval but rate pricing as well.

(3) What are the medications that the applicant is currently taking?

Tip: With hypertension if the blood pressure can not be kept in the normal range with a single medication then a second prescription is usually added. If a combination of prescribed drugs result in failure to preserve a normal range than a third one is added. The more medicated the applicant is as far as treatment, the more severe the hypertensive prognosis is and more likely some form of irreparable damage will develop in major organs. Simply put, if one medication has the same effect as two or three it would be prudent to ask the prescribing physician to consider utilizing a single treatment for underwriting purposes.

(4) Has the applicant had any previous hyperactive complications such as heart disease, TIA, stroke, or kidney problems?

Tip: Hypertension is officially classified as a form of heart disease. The cardiac complications of hypertension could very well include angina, heart attack, coronary angioplasty, coronary artery bypass surgery or heart failure. It is important for a health underwriter to know the intricate details of any possible complications to accurately assess risk. If an applicant has a medical history involving hospitalization for the cardiovascular system in conjunction with hypertension a declination with most major medical carriers is the most probable underwriting decision. If that is the case, consideration of guaranteed or simplified issue plans would be worth entertaining.

(5) Has the applicant undergone any form of cardiac testing?

Tip: The biggest concern with a hypertensive applicant is the potential for heart disease. Applicants who have undergone cardiac testing such as an exercise treadmill with good results may qualify for preferred rates. If documentation is available indicative of the applicants responsiveness to exercising performance, providing such data upon application submission will greatly improve a final underwriting decision making process.

(5) Has the applicant undertaken any lifestyle changes to treat his or her hypertension?

Tip: Weight loss, exercise, low fat diet, and reducing alcohol intake all have beneficial effects on blood pressure. Any of these lifestyle changes also have a positive impact on underwriting decisions. If such information is available from a counselor, dietician, nutritionist, clinician, or any other licensed professional that can attest to this, a certified letter remarking on physical improvement will also expedite and benefit towards the underwriting decision.

If you or someone you know is having a difficult time obtaining an approval for major medical health insurance or receiving standard rating because of high blood pressure, please visit our website at http://www.health-insurance-buyer.com and leave your contact information. One of our licensed agents will contact you to provide the solution.

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