APS Trigger Happy


GA Medicare Expert
5000 Post Club
Some carriers will order an APS over a sneeze, while others only use it for the more serious things.

Several years ago an underwriter told me that probably 90% of the time an APS for health underwriting was a waste of time & money. He said they only alter an outcome in perhaps 10% of the cases.

The carriers I have found who are LEAST likely to order an APS are Aetna, Golden Rule (except for their idiotic HBQ) and KP.

All the others are throwing their money away and making it much more difficult to make a living.
I imagine that with the advent of electronic medical records ordering APS and other documents will speed up the underwriting process.
EHR is still a pipe dream. The APS is a dinosaur that accomplishes very little when used indiscriminately.
I actually take the opposite approach. If I hear of something that might be a red flag, in any way, shape or form, I have the person get the APS from their doc up front, look over it, then run it by the underwriter, and, depending on the situation, submit it with the app.

I explain to people that applying for health insurance coverage is just like applying for the purchase of a house. With a house, your financial past will be scrutinized. With health insurance, your medical past will be scrutinized.

Of the three you mentioned, Somarco, I only write KP. GR, Aetna and CGI aren't worth the paper they're written on (IMHO).

People should be a little "afraid" of insurance companies. We have to remember that health insurance is a priveledge (sp.), not a right. This might do away with some of the hypocondriacal attitudes we have, in this "ask your doctor" world we live in.

That's why I like HDHP's. While they still have underwriting, and at times can be a bit stringent, they might let some minor "ailments" go, knowing that the insured has to foot the bill, up to the deductible. It's amazing, once someone has to pay their own way, suddenly, they don't need as many meds or doctor visits? Ain't that coincidental?

One thing I wish they had here, in Georgia, is Condition Specific Deductibles. It's a great idea, and it treats the insured separate for the specified condition, and leaves the accident and injury portion affordable. At the rate Oxendine approves products, we may get it approved, by the time Mexico becomes our 51st state.