Why Do We Need To Review Medications?

Why do we need to review medications?

Medication review may seem unnecessary in circumstances where the client has permissible conditions.  While carriers/products can restrict coverage based on what meds are prescribed to treat, there’s more they can restrict on:

• Dosage

• Timeframe (when was it first prescribed, when was it last taken, how long has it been taken)

• Quantity of medications for a condition

• Specific combinations of medications

• The medication itself, regardless of any other factor

Because of this, it’s important to remember to ask:

• What is the medication prescribed to treat?
• What’s the dosage of the medication?
• When was the medication first prescribed?
• When was the medication last taken / last filled?

Jane needs coverage. She is on Namenda for Cognitive Impairment. Jane and her son Jim went to the doctor. Jane received a doctors note saying that she doesn’t have Dementia. The application asks only about Dementia and Alzheimers (not Cognitive Impairment). Would she receive coverage?

Probably Not – The carrier might not restrict Mild Cognitive Impairment, BUT they probably restrict Namenda.

Many insurance companies recognize that there are more serious drugs for less serious conditions. Those serious drugs indicate that something worse may be going on. So, as part of being aware of the risk they’re taking on, they decide to avoid it.

Someone is on 7 medications. They say all 7 are for Asthma. Do they have Athma or COPD?

They said they have Asthma, so we should assume they have Asthma!

However, what would the carrier say?  They’d probably say:

Even if they have Asthma, their health is probably comparable to someone with COPD, so we they’ll be underwritten as if they had COPD

It’s important to review medications because:

• It can reveal restricted health conditions
• A client’s coverage eligibility can be changed based on the medication alone or other factors about the dosage, utilization time frame, and combinations of medications

Always get a complete list of medications and ask these questions when you can:

• What is the medication prescribed to treat?
• What’s the dosage of the medication?
• When was the medication first prescribed?
• When was the medication last taken / last filled?

We’d recommend using Quick Reference Guides (like the medication guide at finalexpensechecklist.com), Cheat Sheets, or even something more powerful like Best Plan Pro to help aid in organizing this client data and automatically determining underwriting outcomes (and quotes) based on this health data.

Next: How to Review Medications Effectively