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Medicare Supplement Underwriting Eligibility Questions

Medicare Supplement Underwriting Eligibility Questions

It is not always mandatory to answer Medicare Supplement underwriting eligibility questions when you enroll in a plan. However, it is common to need to go through medical underwriting. Sometimes, like during your Open Enrollment Period, you receive a waiver for health question requirements. Underwriting is likely required if you change your Medigap plan or miss your OEP.

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What Are the Underwriting Questions for Medicare Supplement Plans?

In many states, you need to answer questions about your health and get through underwriting to qualify for new coverage. While medical underwriting can cause some stress, many individuals successfully pass underwriting and change coverage annually, so don’t worry.

Let’s dive into information about the situations typically resulting in approval. Then we can talk about when you may face hurdles in changing plans. This information assists you in understanding if you’re Medigap eligible.

Guaranteed Issue Means No Questions about Health

Each beneficiary has a Medigap Open Enrollment Period when turning 65 and first activate their Part B. After Medigap research, you’ll learn the 6-month enrollment window allows you to apply for a supplement without underwriting. Alternative situations are allowing for a policy without underwriting; this is Guarantee Issue rights.

Medigap’s State Birthday Rule

Five states have birthday rules, which allow beneficiaries to change their Medigap policy around their birthday month with no need for the underwriting process. The beneficiary must already have a Supplement policy that is currently active to qualify. Talk to your agent; they can get quotes to check if a lower rate exists.

If you find a good deal, the application process is quick and easy, especially when there are no medical underwriting questions.

Washington allows supplement eligibility all year; this means that anyone could apply at any time and receive coverage. This also means that rates in Washington for supplements are much higher.

Medicare Supplement Insurance Underwriting Criteria

Now you’re an expert with Guaranteed Issue situations! What you need to know is how underwriting is done through the carriers.

Each carrier has a minimum of one form of health-related questions included in its Medigap application.

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Some of the questions ask if you’ve EVER had a particular condition; however, others inquire about a more recent time. Commonly, questions about the last couple of years of health history.

Answering “NO” to a few or all the medical questions as specified on the applications is recommended.

If you answer “YES” to an inquiry, it can result in an instant decline for most carriers. This means you’re not qualified for any coverage, and there is no need to apply.

Depending on state laws and specific carrier exceptions, it’s best to talk to one of our experts about the possibilities.

In the next sections, I’ll cover some examples of questions that exist in supplement applications.

Medicare Supplement Underwriting Cheat Sheet

When it comes to Medicare Supplement underwriting questions, no two carriers will have the same process. However, if you have any health history it is important to review your diagnosis, treatments, medications, and procedures before completing a Medicare Supplement application.

Whether you believe the information is important or not, everything related to your health must be disclosed on your application form.

Small Health Problems May Result in Approval

When you’re fully healed and done with treatment, then specific injuries are no issue. You will also notice the companies don’t care if the flu got you twice this year or seasonal allergies.

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Cholesterol and high blood pressure are unlikely issues when not occurring with a further or more serious problem.

For example, minor arthritis isn’t problematic, but more severe rheumatoid arthritis could indicate a decline in coverage.

The Body Mass Index isn’t as strict on supplement plans as it is with life insurance. Having those few extra pounds isn’t an issue if you aren’t morbidly obese.

Each company has underwriting guidelines, and your broker will follow company guidelines; this way, you don’t spend time applying when you’d get a denial.

Finish Upcoming Treatments and Pending Surgeries First

There are denial situations, and upcoming procedures are at the top of the list. No company wants to cover you before a costly test or surgery.

Carriers insist that you receive your treatments covered with your previous carrier before applying for new coverage.

Even when your upcoming surgery is not life-threatening, you’ll still need to wait to apply. It’s best to complete your surgery and all follow-up appointments or any required therapy. Once that’s complete, then apply for the new carrier.

Example question from one of our carrier’s applications:

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“Within the last 12-months, have you been advised to have treatment, diagnostic testing, further evaluation, or any surgery that hasn’t been performed?”

Some carriers ask about a specific time frame clear post-surgery, like a knee replacement. Since problems are possible, they can ask you to delay the process for a year or more before applying.

These kinds of requirements vary, and it’s best to ask one of our experts which carriers give you the best chance.

Wait to apply if You had Recent Major Services

If you’ve been hospitalized or if you received home health services two more times within the last couple of years, the carrier may decline you during the application. If you live in a nursing home, you most likely won’t be eligible.

People rarely go from a nursing home or assisted living facility to live independently. You may need to keep your coverage indefinitely.

Sample question from a carrier:

“Are you hospitalized, in a nursing facility or assisted living facility, confined to a bed, receiving home health care, or any physical therapy?”

Cancer is a common concern among applicants. Most carriers want to see at least two years of cancer-free and successful remission before they’ll consider covering you. If you’ve had a recent surgery or you are going through any treatments, you’ll want to wait a couple of years before applying.

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Keep Your Coverage if you have a Chronic, Incurable Condition

There are plenty of health issues that can be treated but are still considered incurable illnesses. When you have an illness that requires treatment forever, you’ll see that there are questions on many Medicare Supplement applications that can exclude you.

Several common examples include:

  • Chronic lung problems
  • Dementia
  • Immune deficiency disorders like MS, RS, AIDS, or Lupus.
  • Nervous system issues, like Parkinson’s

If you have osteoporosis and fractures, this could be problematic. Insurance companies know conditions like this will require a lifetime of care costs.

Heart disorders like this could cause a decline:

  • Heart attack
  • Stents
  • Strokes
  • Arterial and vascular diseases
  • Pacemakers
  • Congestive heart failure

For valve problems and rhythm defects, most carriers will decline coverage. In most circumstances’ organ transplants and kidney failure can indicate a decline.

Medicare Supplement Underwriting Questions for Borderline Conditions

The way a carrier phrases Medigap underwriting questions on their specific application will determine if you can successfully pass the supplement underwriting.

Examples of a common borderline conditions would be diabetes and Mental Health.

If you only take oral medication or you take less than 50 units of insulin, you should receive approval. When you have diabetes, carriers look at additional conditions.

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So, if you have high blood pressure and diabetes with high cholesterol or diabetic neuropathy, then it’s harder to receive approval for coverage.

If you only have diabetes and no related conditions, you should be able to change carriers.

Sample question:

“Do you have diabetes with high blood pressure and require three or more high blood pressure medications to maintain control? Does your diabetes require more than 50 units of insulin each day to control?”

Mental conditions can also be a good example. Typically, if you see a therapist and you take a simple anti-depressant, that isn’t an issue when you have a more severe mental disorder that can cause a decline.

Sample question:

“Have now or within the last two years received treatment for (including surgery), or were you advised by a healthcare professional to receive treatment for severe depression, schizophrenia, a paranoid disorder, or bipolar disorder?”

Declined for Medications

Prescription history records are available to Medigap carriers. On your application, you’ll want to allow the new carrier to obtain your prescription records.

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You must be truthful and try to remember any of the medications that you were recently prescribed.

Auto-Decline Drugs

Of course, Medigap carriers have a list of medications that indicate automatic denial. These medications are ones that treat chronic or significant illnesses.

If you take these medications, you’re indicating that you have a condition that could be costly to cover. Pain medications can be an issue due to prolonged use.

If you take a small round of a declinable drug post-surgery, the company won’t consider this a problem. If you’ve been using it for years, then that could be a potential issue.

Medical Records

Most people don’t know what’s in their medical record history. Think carefully; if a doctor is telling you that you’re pre-diabetic, you’ll need to ask him what he’s submitting to your file. Was the doctor sugar-coating the health condition during the discussion with you?

Telling you that you’re pre-diabetic is less significant, it’s what exists in your file that is key. If your health chart says diabetes, that’s what the carrier will incorporate in the assessment.

Submitting a Medicare Supplement Application With Underwriting Questions

In the past five years, have you been diagnosed, received treatment for, or taken any prescribed medications for:

Even if you answer yes, this helps our brokers to find the most compatible plan and carrier for your needs. Talking to an expert can make applying for coverage simple.

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Identifying the best company for you is simple, and applying is so easy that it can be done over the phone.

Switching supplements is timely, so you should apply for an effective date around 2-3 weeks away. This will give the underwriting department some time to finish your application.

You should expect an underwriter to call you; the telephone interview is a vital part of the carrier’s decision process.

Declinable Conditions When Applying for Medigap?

If you have any of the following health conditions, it’s likely a decline will come from your application. Although talking with an agent can help clear the air.

These conditions are usually an automatic decline:

  • ALS
  • Alcohol/Drug Abuse
  • Alzheimer’s Disease
  • Asthma (with three or more medications)
  • Dementias
  • Chronic Bronchitis
  • COPD
  • Cystic Fibrosis
  • Cirrhosis
  • Congestive Heart Failure
  • Diabetes
  • Emphysema
  • End-Stage Renal Disease (ESRD)
  • Fibromyalgia
  • Heart Disease
  • Hepatitis
  • Immune Disorders
  • Multiple Sclerosis
  • Lupus
  • Kidney Disease requiring dialysis
  • Mental/ Nervous Disorder
  • Myasthenia Gravis
  • Organ Transplant
  • Osteoporosis
  • Stroke
  • Advised to Have Surgery/Treatment
  • Implantable Cardiac Defibrillator
  • Use of Supplemental Oxygen
  • Use of Nebulizer

How to Get Help Understanding Medicare Supplement Underwriting Eligibility Questions

You should never cancel your current coverage before you are approved with your new Medigap carrier. Once approved, you will be notified so you can contact your previous carrier to end coverage.

To contact an agent licensed in your area, complete our contact form here. Or, you can call the number above to speak to an agent now. They will be happy to help answer any questions you have regarding your benefits and medical underwriting questions.

Kayla Hopkins

Kayla Hopkins

Content Editor
Kayla Hopkins is an accomplished writer and Medicare educator serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Insurance Agent, she brings a wealth of knowledge and expertise to her writing.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

42 thoughts on "Medicare Supplement Underwriting Eligibility Questions"

  1. 7 years ago I had an aortic dissection. I have a stent and doctor said over a year ago that I was healed. Does this prevent me from getting a supplement to Medicare?

    1. Hi Cheryl! Every carrier has different regulations when it comes to medical history. So, you may receive a denial from some companies and be approved for others, it just depends how your health history compares to their application questions. It is hard to give you a solid yes or no answer at this moment, but if you are interested in potentially enrolling in a Medicare Supplement plan, one of our licensed agents would be more than happy to review your health history and compare it to each carriers applications to determine which carrier has the best chances of approving you for coverage! If you are interested, just fill out our online rate form and an agent will reach out. Remember, our services are 100% free to use and there is absolutely NO obligation to enroll if you are not satisfied 🙂

  2. I have a cyst that doctors are monitoring and it could require monitoring the rest of my life. Is that disqualifying to chance medigap plans? What I fail underwriting?

    1. Each Medigap carrier requires different Medical questions when going through underwriting. While a simple cyst may not cause red alarms to carriers, if the cyst is cancerous, you may then see an issue when enrolling in a Medigap plan. However, you should never count yourself out. If you wish to enroll in a Medigap plan, the earlier you enroll, the better. Working with an agent who offers multiple carriers is also helpful as you may be a good candidate for one company but not another.

  3. Hi! I have Parts A and B. I would like to get either Plan G or F. I have aortic stenosis and have been having annual follow ups. I do not take any medications. During my last visit on 11/28/23, my cardiologist mentioned an article that she will be mailing to me about a procedure TAVR. She did not say that I should get that done. Her visit summary ended with having me return in 6 months. Can I answer NO to the question: Did you have a procedure not done within the past year? Thanks

    1. If you have not had any physical procedures done in the past year, you can answer “no” to the application question.

  4. I was diagnosed in 2017 with emphysema. I take no medications nor any type of inhaler. I do have a CT of chest yearly to compare size of growth which hasn’t changed much in 6 years. I am 71 and have medical advantage plan. I am thinking of trying to obtain a medical supplement. Looking at underwriting questions, can I say No to the one that asks in the last 5 years have I been diagnosed with emphysema as it was 6 years ago? And as to the question, has your doctor prescribed or treated or had diagnostic testing in last 12 months? I did have CT done and if I answer yes could I be declined? Should I wait a year and then apply so I could answer No to the last question?

    1. Hi Kent! Each Medicare Supplement carrier is different when it come to underwriting. Some carriers are more strict and others may look at your case as an exception. You would be able to say “No” to the emphysema question, however, they would be able to see once they obtain your medical records that this diagnosis was 6 years ago, so that could play a factor. As for the diagnostic testing question, again, it is truly up to the carrier. Was your CT considered diagnostic or was it a preventative care measure? The best way to know for sure is by speaking with an agent who can guide you through the application process and assess your health to help match you to a carrier who will best fit your needs.

  5. I got a pacemaker 8 yrs ago for bradychardia. No problems . I am monitored regularly but no medication
    Can I answer no?

    1. Unfortunately, because you have a pacemaker, you will need to answer yes on your application.

    1. Hi Martha! Each supplemental carrier has a different set of underwriting health questions. However, neither of these conditions strikes me as an automatic decline for any carrier. With that being said, any medications you take are also considered when you apply for supplemental coverage. If you would like, an agent can review your medication list and give you a list of reputable carriers who would accept you onto a plan. To receive that list, complete this online form.

  6. Hi John,
    Your articles are very clear and easy understand.
    My question is: I’m 71yr, female, having advantage plan for 3yrs since starting Plan B in 2019. I’m taking Amlodipine 5mg/day for high blood pressure more than 10yrs. That’s the only medicine I take now. No other medical issues. Could I possibly pass the underwriting to get a supplement plan for a switch to Original Medicare?
    Thank you for your help.

    1. Hi Cathy, each carrier has a different set of underwriting health questions they ask to determine whether or not you will be insured by their plan. There are some carriers who will automatically reject your application due to this drug, however, other carriers may be more lenient. We are more than happy to walk you through the underwriting questions of the carriers to determine which carrier would work best for you. Please complete our online contact form to connect with a licensed Medicare agent!

  7. If I understand this correctly my being Bipolar one will automatically disqualify me from changing my current plan F to a MN plan like plan F as it is less expensive. I will keep current plan until I can’t afford it which is a couple years away. I don’t have guaranteed issue until I turn 65.. My current plan F is really expensive yet to a certain extent pays for itself in no copays. It is really frustrating that I didn’t know to shop around for a plan F when I first qualified for medicare.

    1. Mary, Bipolar Disorder is a pre-existing health condition that will not allow you to switch Medigap plans for most carriers. When you turn 65 you will receive another open enrollment period and will be able to change plans at that time. However, you mention a MN plan, did you recently move to Minnesota?

  8. I am in Idaho which has changed its Medicare law from requiring issue-age to requiring community rated for determining premiums, effective early next year. The new law will provide for a “birthday rule guaranteed issue period”. All of the current issue age will no longer be admitting new members; however, those of us in a current issue age Medigap plans can remain or switch to a community plan with equal or lesser to the plan we are replacing.

    Since I joined my Plan late last year, will it take a few years before my rate grows to what is charged in a community rated plan, thus should I stay on an issue age plan? One possible downside is my issue age plan has only been around a couple of years and does not have a large enrollment base. My percentage increase in premiums for 2022 is much larger than say UHC was for 2022. One insurer, slightly larger than mine, allows switching between Medigap Plans without underwriting, but what I understand it is company policy not in federal or state law.

    Should I attempt to go through underwriting to see if I can make it through underwriting with UHC or Aetna? I take oral medications for diabetes, cholesterol, and high blood pressure. Experience excessive scar tissue buildup. Have multiple trigger finger (tendonitis) and palmer and plantar fibromatosis that I have yet to address. Given all of that, I may have incorrectly thought that I would be disqualified on that basis.

    1. Steve, thank you for the comment. If you haven’t already, check out our article about the changes in Idaho Medigap plans. Speaking with an agent will best determine your ability to pass underwriting health questions. Our agents have access to all carriers available to you and can find the best rates in your area. To get in contact, you can either call the number listed above or complete out online form.

  9. We are being forced to change Medigap insurers by the new company my former employer is making us go through to get reimbursed for our premium costs. From what I understand, any change requires going to underwriting at the new company. Does Pulmonary Fibrosis cause a high chance of being denied insurance or sky rocketing premiums? I’m fighting them now, but my company, that used to handle the reimbursements themselves, has got rid of that department and sent it to a Costa Rica call center. I have been fighting this for 2 months and the deadline for coverage is a week away. It is looking like I will have to change policies or pay on my own. Any info would be greatly appreciated. Also, does BMI affect approval?

    1. Hello – depending on your state of residence, certain pre-existing conditions can disqualify you from acceptance by the carrier. These include COPD. BMI will only affect approval if you are morbidly obese (a BMI of over 40). You are welcome to call our agents at the number above to explain your situation and discuss Medigap options; this service is free and we help clients find coverage nationwide.

  10. I am 74 and had a stent back in 2003. Will I be denied medigap if I apply. Have advantage now. They show I have CAD.

    1. Hi Allen – coronary artery disease is a pre-existing condition, meaning you could face dential from a Medigap carrier during your application process.

  11. I have had Plan G since original enrollment in 2016 and now see the same plan with the same carrier for $50 LESS than I am currently paying. Their agent tells me that they could give me the same deal but now would have to pass underwriting. Apparently recent spine surgery would disqualify me AT THE MOMENT. The agent told me to call back in 2 years as that would no longer be a problem after that length of time. My only other major medical issue was a cardiac event in 2013 that resulted in 2 stents. Does the fact that I’ll have the stents forever disqualify me or does the fact that I’ve had them for over 7 years without further issue mean I would likely pass underwriting? Thanks.

    1. Hi Mike! The stent will not disqualify you. If you’re trying to switch plans with the same carrier, you should have no problem passing medical underwriting.

  12. Is it possible if you originally chose traditional medicare and a med supp when turning 65 to go to a medicare advantage several years later with guarantee issue and within twelve months switch back to traditional medicare and have the option of the one time switch to a supplement without underwriting

  13. I was on SSDI and later I was switched to SSA and Medicare. I was 60 at that time, and it was a surprise to me. I heard nothing about a guaranteed issue. When I turned 65 I had no knowledge of the guaranteed issue. This seems out of the ordinary to me and I’m not sure how to go about rectifying this.

    1. Hi Marge! If you were collecting SSDI you would’ve had two Medigap Open Enrollment Periods that gave you guaranteed issue rights. The first OEP would’ve started the 25th month you were collecting SSDI if you enrolled in Part B. The second OEP would’ve been when you turned 65, assuming you had Part B. If you never enrolled in Part B, then you never triggered your OEP for Medigap. Do you have Part B? If so, what was your effective date? You can technically enroll in Medigap at any time of the year. Depending on your disability, you may still be able to get a Medigap plan even though you have to answer health questions. Some carriers deny you because of certain disabilities, while others will accept you with that same disability. That’s why it’s helpful to work with a licensed Medicare agent.

  14. I currently have Plan N through AARP and seek to mover laterally to another company while retaining Plan N. I am not CHANGING PLANS, just providers. I applied for PLAN N with another insurer and was declined. I pay far more in premiums than they ever pay out for me! I believe if a person is overpaying for a policy with one company they should have the opportunity to simply move to a lower cost provider without underwriting.

    1. Medigap plans are standardized by the federal government. This means all the benefits are the exact same across all carriers, the only difference is the premiums. As long as you pay your premiums, the carrier you’re with cannot deny you coverage due to pre-existing conditions. However, if you want to switch to another carrier, same plan, or a different plan unless you have a Special Enrollment Period, you will have to go through medical underwriting. Even though you want the same plan, you are still switching to another carrier that is new to you and doesn’t know your health history. You could try switching to a different Medigap plan with AARP, in that scenario, they may not require you to go through medical underwriting since you’re already a client. Normally a carrier will accept you into the plan if you’re overall healthy. Did the carrier tell you why you were denied?

    2. Do it around your birthday month if you are in CA or OR. See the instructions about that. That should solve your problem.

  15. Thank you so much. I really appreciate your article as I try and work through this Medicare maze. I live in Florida and am currently enrolled in Medicare Part C insurance through Aetna’s Medicare Supplemental Plan F. I also have a Part D Prescription Drug Plan through WellCare. For cost savings, during open enrollment, I’m thinking of switching to a Medicare Advantage Plan. I understand as part of the “guarantee issue right,” in this first year, I will be able to return to a Medicare supplemental policy and to purchase a Part D plan without any medical questions asked. If this is true, will I be able to return to my original Plan F, since I understand that plan is no longer an option to new enrollees? Also would there be any financial penalty for me if I should switch back?

    1. Hi AnnMarie. Yes, you will be able to use trial-rights to switch back to Plan F as long as it’s within the 12-month time frame. However, make sure your doctors are within the network of your plan. Also, be prepared to have out of pocket costs when you use the benefits. With Plan F, you have 100% coverage. You pay nothing out of pocket outside the monthly premium. Your coverage will be downgraded if you get a Medicare Advantage plan.

  16. My aunt is diabetic and has been taking 40 unit insulin per night, along with oral medications. She is new to Medicare and thinking between keeping original or change to medicare advantage. If she chooses medicare advantage, but later wants to change back to original with a supplement plan. Can she still pass the underwriting health application to have a supplement plan?

    1. Hi Vicky! If she is currently enrolled in a Medigap plan and has been since she was first eligible, then she would be given a trial right. A trial right means you have 12 months to switch back to Original Medicare & pick up a Medigap plan with Guaranteed Issue. However, if she is new to Medicare and never enrolled in a Medigap plan, she would NOT be eligible for a trial right period and would have to answer health questions to change to Medigap at a later time. If she is not yet enrolled in a Medigap plan, but it still in her Medicare Supplement Open Enrollment Period, I would highly recommend she goes with Original Medicare, Medigap, and a Part D plan to make sure she is protected financially. If she cannot afford a Medigap plan, only then would we recommend a Medicare Advantage Plan. I hope this helps!

  17. I have borderline emphyzema with no treatment or meds needed. I have had a heart attack last year. I am on blood thinners, cholesterol and blood pressure meds. I have gout. This is my open enrollment period, is it advisabel to get medigap?

    1. Hi Michael! Yes, I would highly recommend taking advantage of your once in a lifetime Open Enrollment which gives you a Guaranteed Issue Right. This means that none of your previous health conditions will impact your approval or increase your premiums. There’s no cost to you to compare rates in your area. Give us a call so we can help!

  18. Hi. Thanks for the article. I live in North Carolina. This past September I applied for a new Medigap Plan F with lower premiums with the same carrier I already had my Medigap plan with (Aetna) with. I went through the medical underwriting questions with a representative over the phone. When she asked me if I had been diagnosed with osteoporosis within the past 24 months, I said I had been diagnosed with osteoporosis in the past because of a collapsed vertebra (although it was more than 24 months ago), and I have been taking Fosamax for the condition and had no new collapsed vertebrae. They approved me for the new plan. When I received my policy and a copy of the underwriting questionnaire in the mail, I noticed that the Fosamax was not included in the list of drugs I take (although it is the only prescription drug I take). Should I be concerned about that? Does the carrier check medical records before issuing a new Medigap policy? I hope so, because I wanted to be honest and aboveboard with them. I just don’t want any unpleasant surprise in the future, like having my policy rescinded because they thought I had been dishonest!

    1. Hi Dixie! I would not worry about that. Underwriting can pretty much see everything, including your medical records. That drug would not get you declined.

  19. My doctor recommended 49 units of insulin as part of my diabetes treatment. I asked to have it be so that I could get exactly 5 days usage from each Pen. There is no reluctance by my doctor to change the prescription to 49 units. Since the underwriting question uses the word s 50 or more “required” units, am I ok in saying no?

    1. Hi John! If the application says 50 units of insulin or more a week, then you can say no; because you only take 49 units. Although, it’s important to understand that each prescription you fill has a code and if you lie on an application the insurance company will find out. So as long as you’re being honest, you don’t have to worry.


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