Thursday, January 24, 2013

Medical Health Insurance Physicals

Buying health insurance is not an easy task. Because each state is responsible for regulating its own health insurance programs, both the rules and costs can vary widely. In some states, premiums are high, but companies are required to provide coverage to every applicant. Other states have fewer restrictions; therefore, while premiums may be lower, insurance companies can refuse to cover applicants on a variety of different grounds. For this reason, insurers almost always require that applicants undergo physicals, and then use the results to decide if they will insure you.


The purpose of a health insurance physical is to determine whether an applicant is at risk for certain health conditions, which would exclude the person from being insured. Physicals may be at the applicant's expense, or the insurer might pay for the medical examination, although in these cases, a physician chosen by the insurance company typically conducts the exam. While health insurance physicals usually include a physical exam, medical history, and some specific health screenings, they are not meant to be a comprehensive health exam.


If the medical exam is not scheduled with your own physician, you should contact your primary care or family physician immediately should anything of concern show up in the exam. Keep in mind that health insurance physicals are not a substitute for routine medical care.


Underwriters will review the results of the physical exam and any health screenings or lab tests done. The applicant's medical history will also be reviewed. Lab tests ordered may differ based on the applicant's age. Age and health history are major factors considered. Height, weight, blood pressure, pulse, and blood and urine samples are almost always part of the physical. Drug screening is now a common feature, along with cholesterol and diabetes screening. An application is rejected if results show that the applicant is chronically or terminally ill. If the underwriter decides that the insurer may offer you coverage, based on your level of risk, the company will determine the annual premium that you will pay. Underwriting guidelines can differ with separate companies often evaluating the same applicant differently.


Preparing for the exam won't necessarily cover up certain health conditions, but it may help you to get better results. Get a good night's sleep, and avoid strenuous physical activities the day before the exam. Limit your intake of salt and high-cholesterol foods for at least 24 hours before you see the doctor. It is a good idea not to consume any alcohol for at least a couple of days before the exam. Also, stay away from drinking caffeinated beverages such as coffee, tea or cola for several hours before your exam is scheduled.

If you are over age 50, an EKG may be ordered. Ask if you can lie down for the test so that you can relax more. Another caution to consider is that if you regularly use over-the-counter pain relievers such as Tylenol or Advil, long-term use can elevate liver function levels, which may result in an insurer denying you coverage.


While there are some taxpayers who believe that health insurance coverage for children is the responsibility of the parents, the fact is there are millions of working Americans out there who cannot afford health insurance for their families. For those who do not have coverage through an employer, but who can afford to pay the high cost of a private family health insurance plan, eligibility guidelines differ among states allowing insurance companies a good deal of discretion when it comes to deciding whom they will approve for a family policy. Following a mandated physical exam, applicants can be rejected for what seems like a minor medical problem. Some companies assess the risk factors and health history of individual family members even if you are applying for a family health plan. In certain cases, a family may not be able to insure all family members together under one policy.

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