How Prescription Review Works in a Life Insurance Application

If your family’s anything like mine, a trip to the pharmacy is high on the list of normal errands. Medications help us function at our best and defeat the latest illness to come out of the playground petri dish. Medications are a good thing—but they can make a difference when it’s time to get life insurance.

It’s true that certain prescriptions can raise a warning flag for insurance underwriters, but there’s more to your health story than a single medication. Your health and prescription history are complex and specific to you. Here’s how underwriters gather the full picture and what it might mean for your rates.

How Life Insurance Companies Collect Prescription Information

Life insurance companies rely on a few different sources to get the information they need to review your application.

The first major source, of course, is you. When you fill out your application, you’ll be asked to provide a list of medications you take, dosage and why you take them. Be as thorough as you can. The clearer the information you can provide, the smoother it tends to go as underwriters move through other steps of the review process.

Underwriters also check medical databases to get more details about your health history. The databases may collect information from health insurance providers, pharmacies, doctors’ reports or other sources. The information is HIPAA protected, so you authorize this search with a form included in your application.

If underwriters still need more information, they may ask you to provide an attending physician statement (APS), which entails your medical records or more detailed information and context on a condition or treatment plan that an insurance provider wants to know more about.

Why Underwriters Check Prescription History

If you report your own prescription details, why do underwriters still check a third-party medical database? Do they not trust you?

The life insurance application process isn’t like a TV police interrogation—underwriters aren’t trying to trap or accuse you. Their role is to get the most complete, accurate and well-rounded view of your health as possible. Medical databases help verify what you’ve already shared in applications or cover details you forgot about.

Because a life insurance policy is a legal agreement, it’s important for your rate and coverage that all the information is accurate. Underwriters review and consider information you report carefully, and they also want to fill any gaps in their understanding with resources like a database. If they find something that seems inconsistent, they may need to come to you for more clarification.

How Prescription Drugs Affect Your Rates

One common myth is that prescription medications will increase your rates or make insurance companies deny your application altogether. This may sound like a fine distinction, but it matters—your health condition is typically the more important factor affecting your rates.

Think of it like this: If you have a heart condition or a mental health condition like depression, you may manage it with medication. Dropping the meds could lead to serious consequences for your health, or possibly land you in the hospital. A prescription medication can be one sign to an underwriter that a condition is on the more serious side, but not taking medications you need wouldn’t change the reality of having that condition. Following whatever treatment plan is best to control any medical conditions you have is the best choice for your health and your life insurance policy fit.

Medications likelier to increase rates

With that in mind, the most likely prescription drugs to catch an underwriter’s attention are the ones associated with medical conditions that are a higher risk. Some serious conditions might include:

• Cancer

• Diabetes

• Heart disease

• High cholesterol

• Seizures

• Immune diseases

If you need medication to control diabetes, blood pressure or cholesterol, your condition is probably serious enough that you may face higher rates that align with the higher risk. If you are taking a medication that has an effect of suppressing your immune system, that could also increase your risk.

Prescription medications that don’t affect rates

On the flip side, there are plenty of prescription medications that may show up in your history but have little or no effect at all on your life insurance application.

Thanks to modern medicine, it’s easy to treat a sinus infection with a course of antibiotics. Generally, you can expect that a prescription to treat winter sniffles won’t matter for your rates.

Life insurance underwriters generally care about health conditions that increase your chances of dying sooner. Conditions that are unpleasant but not life-threatening aren’t their priority. A prescription athlete’s foot treatment might not raise warning flags (provided there aren’t other factors at play, like diabetes or immune disorders, that could complicate the condition).

In other cases, people have a prescription “medication” like birth control even if they’re in perfect health. Again, life insurance underwriting is about evaluating risks standing in the way of you living a long life, not screening for prescription-free people. A medication won’t affect your rates if it doesn’t affect your risk.

How You Use Medications Matters

Some medications are best known for treating a particular condition, but they can also be used for very different situations.

Some insurance companies take different stances than others if you use a medication for a different reason than its primary use. If you’re taking a prescription drug that treats a high-risk condition, even if you’re taking it for a different reason, some insurance companies may still rate you in a riskier class. Other companies may draw more of a line between using a drug to treat a serious condition or taking advantage of side benefits to treat a less severe condition.

The medication itself can impact your application if it has potentially harmful qualities in its own right. For example, if you deal with hot flashes or nightmares, those are very annoying for you, but they don’t matter to an underwriter (or your policy rates). If you treat them with long-term use of a medication that increases your risk for liver trouble, that could be much more of a warning flag.

Some medications can also interact with other drugs in ways that affect your health. If you have a long list of prescriptions, that might be more complicated to insure because of the potential of different conditions or drug interactions affecting each other.

Ultimately, an underwriter is working with your specific case. Your prescription list, dosage, duration of treatment, health conditions and other factors all matter. An underwriter uses risk formulas but also their own judgment to understand your situation as clearly as they can.

Ways to Lower the Impact of Prescriptions on Your Life Insurance Application

There are a few tips for making the most of the prescription section of your application:

• Be open on your application: Life insurance contracts are based on you providing honest answers about your own health and lifestyle. A prescription review on a database will help close gaps, but your application is a great place to provide context in your own words about your health and answer underwriters’ questions.

• Take your meds: A good way medications impact your life insurance application is if you are taking necessary meds on schedule and keeping your medical conditions well managed. Managing without medications may be the best-case scenario, but taking meds is better than living with an uncontrolled health condition.

• See your doctor regularly: Prescription needs can fluctuate, so regular check-ups can help ensure you’re on the right dosage.

• Live a healthy lifestyle: Certain conditions respond well to overall healthy actions, like eating your greens or exercising regularly. If your lifestyle helps you control a condition at a lower drug dosage, that might be a good sign for your risk rating.

• Correct prescription review errors: We’re all human, including the people managing the big medical databases. If you spot something that looks incorrect or is missing critical information, underwriters want to know. You can check and correct your profile with MIB Group, a major database, and you can contact life insurance customer support if you spot an error they should know about.

A clear, detailed account of your medications is more likely to help your application process go as smoothly as possible. You can play an active role in helping underwriters understand the context.

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