Do health insurance companies require a medical exam?


Currently, there are some insurance companies who do, and there are some who don't. You see, one's medical condition is one of the bases for underwriting a health insurance policy in the past. As a result, insurance companies sometimes charge sky-high premiums to those who have pre-existing conditions, or worse, they may even deny coverage.

But, when the healthcare reform bill fully kicks in, one's medical condition may not be part of the underwriting process. The insurance company will not be able to charge higher premiums based on your health nor refuse to issue you with a policy.

Currently, health insurance companies may require the following:

  • Waiting Period.

    The insurance company may immediately issue the policy and have it effective immediately. However, it will also require a waiting period for some illnesses. This means that you can't claim with regards to the illnesses if the claim happens within the waiting period.

    Waiting periods may range from 3 months to 1 year, depending on the insurance company that issued the policy. With this kind of policy, you don't need to undergo medical exams.

  • Full Medical Declaration (FMU).

    A Full Medical Declaration requires that you submit your medical records. The underwriters will determine if further tests will be needed and they will say which tests will be required. You may have to go through urine tests, blood tests and other diagnostic exams, as required by the underwriters. You will also be required to have a check up with a doctor who is accredited by the health insurance company. The underwriters may specify a waiting period depending on the results of your exam.

The good thing about the healthcare reform bill is that it may very well eliminate the need for medical exams since insurance companies will be required to base premiums on age and not on health.

Was this question and its answer useful?
Not a bit
  • Currently 4.3/5 Stars
  • 1
  • 2
  • 3
  • 4
  • 5
Very useful
Have a question about insurance? Ask the experts