Orlando Harmon
When applying for life insurance, you will be asked to provide your prescription history. This information is used by the insurance company to assess your health and price your policy accordingly. With your consent, they can access medical databases to verify the information you've provided and fill in any gaps. Companies like ExamOne and Milliman IntelliScript gather prescription claims data from pharmacy benefit managers and sell reports to insurers. These reports can include the drug name, dosage, fill date, and pharmacy and physician information. Life insurance companies use this data to streamline the application process and reduce costs. It's important to be honest about your prescription history, as discrepancies between your application and the data can affect your policy.
| Characteristics | Values |
|---|---|
| Prescription history | Used to fill in gaps in the applicant's memory or to verify the information provided by the applicant |
| Prescription databases | ExamOne's ScriptCheck, Milliman IntelliScript, MIB |
| Prescription history check | Helps to qualify for coverage, speed up the approval of applications, and streamline the process |
| Prescription data | Drug name, dosage, fill date, pharmacy and physician information |
| Prescription data sources | Health insurers, pharmacies, medical service providers, pharmacy benefit managers |
| Prescription data age | Probably don't date back more than 10 years |
| Prescription data consent | Requires prior written consent from insurance applicants |
| Prescription data regulation | Tightly regulated under the Health Insurance Portability and Accountability Act |
| Prescription drugs | Antibiotics, medication for asthma, barbiturates, benzodiazepines, anabolic steroids, marijuana, cocaine |
What You'll Learn
Prescription history and insurance rates
Life insurance companies use large databases of prescription histories, and this information is aggregated from primary sources like health insurers, pharmacies, and medical service providers. The data is regulated under the Health Insurance Portability and Accountability Act (HIPAA). Companies like ExamOne and Milliman IntelliScript gather prescription claims data and sell reports to insurers, including the drug name, dosage, fill date, and pharmacy details. This data helps insurers streamline the application process, reduce costs, and speed up approval.
It is important to be honest when disclosing your prescription history to life insurance companies. While certain medications may not automatically disqualify you from coverage or increase your rate, omitting them from your application may create discrepancies and affect the insurer's assessment of your health. A prescription history can be indicative of a range of medical conditions, and underwriters review applications on an individual basis to understand the context of the prescriptions.
Insurers use underwriting algorithms and, if needed, human underwriters to review applications and verify information. They take a holistic view of customers and aim to provide the most accurate rates. Providing detailed and accurate prescription information can help secure the best life insurance rate.
Star Union Dai-ichi Life Insurance: Comprehensive Guide
You may want to see also
Databases and prescription history
When applying for life insurance, you will be asked to provide your prescription history. The insurance company will assume that the prescription history you provide is accurate and use it to underwrite your policy. They will also use medical databases as an additional source of verification, or to help fill in gaps in the applicant’s memory. This is standard practice for all major life insurance companies, and the data is aggregated from primary sources like health insurers, pharmacies, and medical service providers.
Insurers can buy data about applicants from a variety of sources, including companies like LexisNexis, which scan public records, and ExamOne, a part of Quest Diagnostics. ExamOne's ScriptCheck® service helps insurers develop a more in-depth review of applicants’ prescription histories. They work with some of the largest pharmacy benefits management (PBM) companies and collect pharmacy claims regardless of where the prescriptions were filled. ExamOne requires prior written consent from insurance applicants, which appears in the HIPAA-compliant authorization that is part of the insurance application.
Milliman IntelliScript also gathers prescription claims data from pharmacy benefit managers and sells reports to insurers. These reports can include the drug name, dosage, fill date, pharmacy, and physician information. The prescription history data that is sold to life insurance companies probably doesn’t date back more than about 10 years, as it’s only been in the past decade or so that such information has been captured electronically.
The prescription history data that insurers buy is tightly regulated under the Health Insurance Portability and Accountability Act (HIPAA). This data can speed up the approval of most applications and help insurers to streamline the application process and reduce their costs to issue policies. In some cases, the reports might reveal discrepancies between what applicants disclosed and the data, prompting the insurer to ask for more information. For example, if an applicant says they are in perfect health but are taking medication for a condition, the insurer will want to know more. However, a medication history check could also show that an applicant has been filling a prescription consistently to keep a condition under control, which could help them qualify for coverage.
Life Insurance: Does Provider Matter?
You may want to see also
Prescription history and insurance applications
Prescription history is one of the factors that life insurance companies consider when reviewing applications. This is because prescription history can provide valuable insights into an applicant's health situation and potential mortality risk. While the impact of prescription history on life insurance rates depends on individual circumstances, it is essential to understand how this information may be used in the underwriting process.
Life insurance companies typically use prescription databases as an additional source of verification or to fill in gaps in an applicant's memory. They do not use this information to play "gotcha" but rather to support the customer's provided information. These companies have access to large databases of prescription histories, which are aggregated from primary sources like health insurers, pharmacies, and medical service providers. The data is regulated under the Health Insurance Portability and Accountability Act, ensuring its security and privacy.
When applying for life insurance, it is crucial to be honest about your prescription history. Omitting certain medications from your application will not conceal them from the underwriter, as they have access to comprehensive prescription drug history through their sources. Additionally, providing accurate information about your prescription history helps the insurance company assess your overall health and price your policy accurately.
In some cases, a medication history check can even work in your favour. For example, it could show that you have been consistently filling a prescription to manage a condition, which may help you qualify for coverage. On the other hand, discrepancies between your disclosed information and the data may prompt the insurer to request additional details. Therefore, it is always best to be transparent and provide a holistic view of your health situation.
It is worth noting that the prescription history considered by life insurance companies may not extend far into the past. Due to the recent shift towards electronic data capture, the prescription histories sold to these companies typically cover around ten years. Additionally, the interpretation of prescription history is not always straightforward, as the same medication can be prescribed for different conditions in different fields of medicine. As a result, applicants are reviewed individually to understand their unique health context.
Assigning Life Insurance: Bank Benefits and Procedures
You may want to see also
Prescription history and insurance coverage
When you apply for life insurance, disability insurance, or any supplemental coverage, the insurance company will request medical and prescription history. This information is used to assess your overall health and accurately price your policy. The prescription history you provide in the application process is assumed to be accurate and is used as a verification tool. It is also used to help fill in gaps in the applicant's memory.
Insurers can buy data about you from a variety of sources, including public records and data collected by MIB, prescription databases, lab results, and motor vehicle records. ExamOne, a part of Quest Diagnostics, and Milliman IntelliScript gather prescription claims data from pharmacy benefit managers and sell reports to insurers. These reports include the drug name, dosage, fill date, pharmacy, and physician information. The prescription histories sold to life insurance companies probably don't date back more than about 10 years, as electronic record-keeping of such information is a relatively recent development.
It's important to note that a prescription history is never black-and-white. The same medication could be prescribed for different conditions in different people, and applicants are reviewed on an individual basis to understand their health situation. However, omitting certain medications from your application in hopes of concealing them is not advisable, as insurance companies utilize large databases of prescription histories as standard practice. This data is aggregated from primary sources like health insurers, pharmacies, and medical service providers, and is regulated under the Health Insurance Portability and Accountability Act.
Inaccurate prescription history reports can have negative consequences, including denial of insurance or high insurance premiums. Under the Fair Credit Reporting Act (FCRA), consumers have the right to see what is in their report, receive a copy of the report, and be notified if information in the report is used against them.
Life Insurance: How Long Should You Keep It?
You may want to see also
Prescription history and insurance exams
Insurers can access your prescription history through various means. They will often use third-party data sources, such as ExamOne's ScriptCheck®, which aggregates prescription data from pharmacy benefit managers and sells reports to insurers. These reports can include the drug name, dosage, fill date, pharmacy, and physician information. Insurers may also use other data sources, such as lab results, motor vehicle records, and public records, to assess your application.
It is important to note that insurers will typically only have access to your prescription history if you provide consent. The authorization to access this information must be signed and dated prior to the insurer accessing your prescription history. Additionally, the information is tightly regulated under the Health Insurance Portability and Accountability Act (HIPAA), ensuring your data is protected.
When reviewing your prescription history, insurers are looking for accuracy and detail. They will compare the prescription history you provide in your application with the information from medical databases to verify its accuracy and fill in any gaps. This process is often done using innovative underwriting algorithms, and if further clarification is needed, a human underwriter will review the information and ask follow-up questions.
Being honest and providing as much detail as possible about your prescription history is crucial. Omitting certain medications from your application in hopes of concealing them is not advisable, as insurers have access to comprehensive prescription databases. Additionally, your prescription history can work in your favour. For example, consistently filling a prescription to keep a condition under control can demonstrate responsible health management and may help you qualify for coverage.
Life Insurance Trusts: Grantor Trust Status Explained
You may want to see also
Frequently asked questions
Life insurance companies use prescription databases to check an applicant's prescription history. This is to verify the information provided by the applicant and to fill in any gaps in the applicant's memory.
Prescription databases contain information on an individual's prescription history, including the drug name, dosage, fill date, pharmacy, and physician information.
Prescription histories sold to life insurance companies probably don't date back more than about 10 years, as it has only been in the past decade that such information has been captured electronically.
Yes, your prescription history can affect your life insurance rates and eligibility. However, it depends on your individual circumstances and the specific policies of the insurance company. For example, some companies may not be concerned about marijuana use, whereas others may be.
