After practicing medicine for 20 years, I’ve become adept at “clarifying” to life insurance companies why patients are taking certain medications. The same medications appear to trigger red flags for both long-term care and life insurance companies.
Their “concern” makes sense for some medications because they are used for serious chronic illnesses, but for others, the insurance companies are worried about your lifestyle. Most on this list are important medications so do not stop taking them because you’re concerned about rejection and do not omit them from your forms. Instead, along with your physician, you can clarify and appeal their decision.
Here are the ten worst medications to be taking that will trigger a “no” or a further review if applying for life insurance or long-term care insurance.
- Namenda (memantine) or Aricept (donepezil). One of the more obvious red flags, dementia is expensive for Long-term care insurance plans because folks with dementia are often physically healthy and their care is expensive. Pro tip: be careful here because Namenda is also prescribed for migraine prevention and may trigger an unnecessary alarm.
- Hydrocodone, oxycodone, morphine aka “Opioids.” Long-term use of pain medication raises red flags for insurance companies and almost always results in a closer review. Why? Because costs associated with chronic pain patients taking opioids are substantial and range from 560 to 635 billion per year in the U.S. in 2010. Insurance companies run for the hills because of that.
- Xanax (alprazolam), Ativan (lorazepam) and Valium (diazepam) are benzodiazepines that will lead to a closer review of your application. Why? Several studies have shown an association between benzodiazepines and risk of death. In folks 65 years or older benzodiazepines increase the risk of falls and fracture-related mortality. Some studies have found a threefold or higher increase in the risk of all-cause mortality among adult populations using benzodiazepines even for durations shorter than one month.
- Lithium and Divalproex. Life insurance companies love to hate bipolar medications because suicide rates in bipolar patients average approximately 1% annually, or 60 times higher than the international population rate. Pro tip: If you take Valproic acid for migraine prevention or trigeminal neuralgia you will want to clarify if turned away.
- Paxil (paroxetine), Lexapro (escitalopram), Celexa (citalopram), Zoloft (sertraline) aka the “SSRI” antidepressant medications. This is one of the common reasons my patients are turned away, and yes you can appeal and clarify this. Why are life insurance and long-term care insurance plans worried? Because of the risk of suicide and increased use of healthcare resources in folks with depression and anxiety.
- Plavix (clopidogrel). This is another common medication that will often lead to a “no”. Clopidogrel is used for the treatment of coronary artery disease and atherosclerosis – often given to patients who have had stent placement for coronary artery disease. This puts you in a high-risk category and insurance companies don’t like that.
- Arimidex (anastrozole) or tamoxifen. These are medications taken long term to prevent the recurrence of breast cancer. Even though cancer outcomes have been improving dramatically in recent years, life insurance companies continue to see cancer as a high-risk situation. Breast cancer receives quite a bit of scrutiny from insurance companies.
- Naltrexone, Campral or Antabuse (disulfiram) are medications used for the treatment of alcohol abuse and that sends insurance companies running for the hills. Insurance companies don’t like alcohol overuse or abuse to be part of your history and this medication is used to help with alcohol cravings and will trigger a red flag.
- Harvoni, Sovaldi, and Viekira Pak. Medications used for the treatment of Hepatitis C will cause insurance companies to balk at your application. Pro Tip: Here is a perfect example of where you can file an appeal and have your doctor help with clarification especially if you have achieved cure (sustained virologic response) of your Hepatitis C.
- Atripla and Genvoya are commonly prescribed combination HIV medications and will often trigger a “no” for long-term care and life insurance policies.
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