Medical Underwriting Questions

• Have you been hospitalized within the past 90 days or three or more times within two years?
• Are you currently hospitalized or scheduled for hospital admission?
• Have you been diagnosed with a terminal illness?
• Are you confined to a bed or nursing facility?
• Have you lived in a nursing or assisted living facility within the past two years?
• Are you receiving home health care or have you required multiple periods of care within two years?
• Do you need assistance bathing, dressing, eating, toileting or transferring?
• Have you been advised to use a wheelchair, walker or motorized mobility aid?

Have you been diagnosed with, treated for or advised to receive treatment for:

• Heart attack or heart failure?
• Coronary artery disease, angina or blocked arteries?
• Atrial fibrillation or irregular heartbeat?
• Cardiomyopathy or enlarged heart?
• Pulmonary heart disease or ventricular tachycardia?
• Stroke, mini-stroke (TIA) or carotid artery disease?
• Peripheral vascular disease or atherosclerosis?
• Heart bypass surgery, angioplasty or stent placement?
• Heart valve surgery or pacemaker implantation?
• An implantable cardiac defibrillator or unrepaired aneurysm?

Many questions use two- or five-year lookback periods. Certain conditions may be reviewed over a lifetime.

• Do you have diabetes with neuropathy or retinopathy?
• Do you have diabetes-related kidney problems or proteinuria?
• Do you have diabetes with vascular disease or circulation problems?
• Do you require more than 50 units of insulin daily?
• Do you have diabetes and hypertension requiring three or more blood pressure medications?
• Do you currently use tobacco products and have diabetes?

Diabetes without complications may be treated differently from diabetes with complications.

• Have you been diagnosed with or treated for cancer within the past two or three years?
• Have you had leukemia, lymphoma or multiple myeloma within the past five years?
• Have you had malignant melanoma or metastatic Merkel cell carcinoma within the applicable lookback period?
• Are you currently receiving cancer treatment?
• Have you been advised to undergo additional cancer-related tests, biopsies or treatment?
• Are you awaiting cancer-related diagnostic test results?

Some insurers exclude certain non-melanoma skin cancers.

• Have you been diagnosed with chronic kidney disease (CKD)?
• Have you had renal insufficiency or renal failure?
• Have you been diagnosed with end-stage renal disease (ESRD)?
• Have you received dialysis or been told you may require dialysis?
• Have you received treatment or advice for kidney problems within the past two years?
• Do you have diabetes-related kidney complications?

Some questionnaires exclude kidney stones from certain kidney disease questions.

• Have you been diagnosed with COPD or emphysema?
• Have you been diagnosed with chronic bronchitis or cystic fibrosis?
• Do you have a respiratory condition requiring permanent oxygen?
• Do you use a nebulizer to treat a respiratory condition?
• Do you take three or more respiratory medications?
• Do you use tobacco while being treated for a respiratory disorder?
• Have you received IV infusions or injections for asthma within the past two years?

• Have you been diagnosed with Alzheimer’s disease or dementia?
• Have you been diagnosed with Parkinson’s disease?
• Have you been diagnosed with multiple sclerosis (MS) or ALS?
• Have you been diagnosed with muscular dystrophy or cerebral palsy?
• Have you been diagnosed with an organic brain disorder?
• Have you experienced paralysis, quadriplegia, paraplegia or hemiplegia?
• Have you received treatment for seizures within the past two years?
• Have you received IV infusions or injections for migraine headaches or cognitive impairment?

• Have you been diagnosed with rheumatoid or psoriatic arthritis?
• Have you been diagnosed with disabling arthritis or Paget’s disease?
• Have you been diagnosed with lupus or myasthenia gravis?
• Have you had osteoporosis with fractures or requiring injections?
• Have you been diagnosed with spinal stenosis?
• Have you received IV infusions or injections for autoimmune disorders, osteoarthritis or connective tissue disorders within two years?

• Have you been diagnosed with cirrhosis or liver fibrosis?
• Have you been diagnosed with liver failure or chronic liver disease?
• Have you been diagnosed with hepatitis other than hepatitis A?
• Have you received treatment for pancreatitis?
• Have you been diagnosed with Addison’s disease?

• Have you been diagnosed with bipolar disorder or schizophrenia?
• Have you been diagnosed with a paranoid disorder?
• Have you been treated for severe depression?
• Have you been treated with medication for depression for two or more years?
• Have you received treatment or counseling for alcohol or drug abuse within the past two years?

Mental health underwriting differs among insurance companies.

• Have you been diagnosed with hemophilia or another significant blood disorder?
• Have you required repeated blood transfusions for anemia?
• Have you received IV treatments for primary immunodeficiency syndrome?
• Have you received blood transfusions or skin grafts within the past two years?
• Have you received IV infusions or injections for blood, immune, genetic or hereditary disorders?

• Have you received an organ transplant?
• Have you been advised that you may need an organ transplant?
• Have you received or been advised to receive a bone marrow or stem cell transplant?
• Have you experienced an amputation caused by disease?
• Have you been advised that an amputation may be necessary?

Some applications exclude corneal transplants.

• Have you been diagnosed with wet macular degeneration?
• Have you received IV infusions or injections for an eye disorder?
• Have you tested positive for HIV or been diagnosed with AIDS or an AIDS-related condition?
• Have you had a PSA level greater than 6.0?
• Do you currently use nicotine and have a heart condition, vascular disease or diabetes?

• Have you been advised to undergo surgery that has not yet been performed?
• Are you scheduled for surgery?
• Are you awaiting biopsy or diagnostic test results?
• Have you been advised to undergo additional medical testing or evaluation?
• Have you been advised to receive treatment or therapy that has not been completed?

Routine preventive screening may be excluded by some insurers.

• What prescription medications have you taken within the past two years?
• What conditions are your medications used to treat?
• Have you recently changed medications or increased dosages for a cardiovascular condition?
• Do you currently use tobacco or nicotine products?
• What is your current height and weight?