Some health insurance plans, like group employer plans, do not require you to prove you are insurable prior to issuing coverage. As of 2010, however, many individual insurance plans collect medical information about you as part of the underwriting process and can still use it to determine whether or not to issue you a policy and what they will charge as a premium. The required information varies by company and state law, but the sources of information generally remain the same. Some of this is subject to change as aspects of the Patient Protection and Affordable Care Act of 2010 are phased in.
Insurance Application
If medical underwriting is required for the insurance plan you desire, there will always be a medical questionnaire as part of the application form. Expect thorough questioning about every body part and organ system you have, regardless of which company you choose. There may be questions about your smoking and drinking habits, as well as family history of chronic diseases and cancer. Most applications will have a final question asking you to detail any medical problems, current or former, for which no specific questions appear earlier on the questionnaire. With these questions, the insurer attempts to identify the likelihood of you requiring major medical attention so it can decide whether or not it wants you as a customer.
Medical History
Don't be surprised if the health insurer requests a copy of your medical records from your current doctor. This is to verify the information you list on the application, catch conditions you may have omitted from the application and get medical diagnoses and treatments for any condition you may have. The application itself likely requires you to list actual dates of office visits and reasons for service for the previous five years, so the insurer may want to see corresponding medical records for that same period of time.
Medical Information Bureau
Some medical records are submitted to the Medical Information Bureau. Formed in 1902, the Bureau consists of over 400 member insurance companies in the United States and Canada. Its primary goal is to protect the insurers from intentional omissions by applicants regarding medical issues for life, health, disability income, critical illness and long-term care insurance. Your health insurer will likely utilize the Bureau's data records to underwrite your application. The Bureau can provide a more detailed history for individuals who may have changed locations and doctors a number of times.
Tags: medical records, health insurer, Information Bureau, insurance plans, Medical Information
