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February 1, 2018
Can I get a Medigap plan if I’m overweight or obese?

Can I get a Medigap plan if I’m overweight or obese?

Insurance underwriting can be really confusing – how do you know if you’ll be approved for a plan?

For those of you who don’t know, underwriting is a process that insurance companies go through where they assess risk – how risky are you to insure?

During this underwriting process, the “underwriters” will take a look at your medical records, your prescription drugs, and most of the time, they’ll even do a short phone interview.

Their goal is to approve healthy individuals and decline unhealthy individuals. So, what happens if you’re overweight or obese?

Height/Weight Charts

Most insurance carriers have a height and weight chart. The chart will show the minimum and maximum weights they’ll accept depending on your height. If you fall out of the range in the chart, you will be automatically declined.

However, some carriers do have additional rate classes if you’re outside of their normal range.

For example 2 of our carriers have 3 rate classes total:

  1. The first offers the best rates to those within the standard weight range.
  2. The second adds 10% to the monthly premium and has a more lenient weight range.
  3. The third adds 20% to the monthly premium and has the most lenient weight range.

One thing to note is that if you’re just overweight, you shouldn’t have any problem being accepted by nearly any carrier. If you’re obese, you may run into some issues, though many carriers still offer a wide range of acceptable weights.

We compared height and weight charts between over a dozen carriers, and we found that most of their charts tended to follow a specific pattern – BMIs.

BMI Chart

While insurance carriers don’t actually mention BMIs in their applications or height and weight charts, we noticed a pattern.

Most carriers have a weight range that falls into a specific BMI range. That can make it easier for you to determine how insurable you are when it comes to Medicare Supplements.

Here is a link to a BMI calculator: http://www.calculator.net/bmi-calculator.html

Enter your age, gender, height, and weight, and keep your BMI in mind. We’ll go over some examples of BMIs that are insurable vs BMIs that are automatically declined.

What weight ranges are accepted vs. declined?

As with most health conditions, every carrier has their own guidelines for what they’ll approve and what they’ll decline.

After comparing over a dozen carriers, we noticed that many of them happily accept individuals with BMIs up to about 40. Some carriers will go as high as 41, but anything above that is likely to be an automatic decline.

Some carriers reward individuals for having a lower BMI by offering preferred rates. For carriers that have multiple rate classes based on your weight, the preferred BMI range can actually vary. One carrier has a BMI range of 17-30, another 17-35, and yet another 17-40.

If you could lose a few pounds in order to make it into the accepted or preferred weight range, it’s worth giving it a shot! Not only is this going to be better on your joints and overall health, but you could save yourself a lot of money.

What if my weight is outside the accepted weight range?

If your BMI is too high, you may have one final option – you can take advantage of open enrollment and Guaranteed Issue (GI).

Open enrollment is when you’ve signed up for Medicare Part B for the first time. In this situation, you don’t have to answer any health questions.

Guaranteed Issue (GI) is a little bit more complicated, but here are a couple common examples:

  • You’re in a Medicare Advantage Plan, and you move out of the plan’s service area.
  • Your employer’s group health plan is ending.

Read more about open enrollment and Guaranteed Issue here.

So, if you qualify for open enrollment or Guaranteed Issue (or both at the same time), you don’t have to pass medical underwriting at all.

As always, it’s important to talk with an agent to determine what plans are available in your area and what their specific height/weight chart is. If you’d like us to check your eligibility and provide quotes, simply click on the button below.

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