Final Expense Grid Sheet

[Pages:14]FINAL EXPENSE GRID SHEET

SEE LAST PAGES FOR PRODUCT OVERVIEWS AND HEIGHT AND WEIGHT CHARTS

ILLNESS / CONDITION

AIDS/HIV/ARC

EAGLE PREMIER DECLINE

ACCENDO DECLINE

AFIB - ATRIAL FIBRILLATION / IRREGULAR HEARTBEAT

Not asked - Allowed

Not asked - Allowed

ALCOHOL / DRUG ABUSE

within 2 yrs - Guaranteed Treatment within the

Issue

past 2 years ? Modified

NEW VISTA DECLINE

Not asked - Allowed

Within 2 years Modif ied

SENIOR CHOICE DECLINE*

(See personal State application)

Not asked - Allowed

PLAN RIGHT DECLINE

Not asked - Allowed

Treated within 2 years ROP

Treatment within the past 2 years ?Basic

LIVING PROMISE DECLINE

Within 2 yrs - Graded within 2 yrs - Graded

ALS (LOU GEHRIG'S)

Guaranteed Issue

DECLINE

DECLINE

DECLINE

DECLINE

DECLINE

ALZHEIMER'S / DEMENTIA / MEMORY LOSS / COGNITIVE

AMPUTATION

Guaranteed Issue

Due to Diabetes DECLINE

DECLINE

Modif ied Due to any disease or Diabetes - DECLINE

DECLINE

Due to Diabetes Modif ied

DECLINE

Caused by disease DECLINE

DECLINE DECLINE

DECLINE

Due to Diabetes DECLINE

ANEURYSM ANGINA (CHEST PAIN)

ANGIOPLASTY

Not asked - allowed

Within 1 Year - Modified Within 2 years - Modified

Within 2 yrs - ROP

within 1 yr - Guaranteed Issue

Treated Within 1 year Modified; Between 1-2 years - Standard; > 2 yrs-

Preferred

Within 2 years - Modified

Within 2 yrs - ROP

within 1 yr - Guaranteed Issue

See Heart Surgery

Within 2 years - Modified Not asked - Allowed

Within 2 years - Basic

Not Allowed - asked

Treated within 1 year Basic; Within 2 years -

Standard

Within 1 yr - DECLINE; Within 2 yrs - Graded

See Heart Surgery

Within 1 yr - DECLINE; Within 2 yrs - Graded

ARTHRITIS

Not asked - Allowed

AFIB - ATRIAL FIBRILLATION /IRREGULAR HEARTBEAT

Not asked - Allowed

ASSISTED LIVING / LONG TERM CARE FACILITY

within 6 months Guaranteed Issue

Not asked - Allowed Not asked - Allowed

DECLINE

Not asked - Allowed Not asked - Allowed Current - DECLINE

Not asked - Allowed Not asked - Allowed

DECLINE

Not asked - Allowed

Not asked - Allowed

Not asked - Allowed

Within 2 yrs- Graded

DECLINE

Current - DECLINE

FINAL EXPENSE GRID SHEET

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ILLNESS / CONDITION

ASTHMA (CHRONIC)

EAGLE PREMIER Not asked - Allowed

ACCENDO Standard

NEW VISTA Not asked - Allowed

SENIOR CHOICE Not asked - Allowed

PLAN RIGHT Not asked - Allowed

LIVING PROMISE Not asked - Allowed

AUTISM

Not asked - Allowed

See Mental Incapacity

Graded

Not asked

Not asked

DECLINE

BIPOLAR

Not asked - Allowed

Preferred

Graded

Not asked - Allowed

Preferred

Within 4 yrs - Graded

BLACK LUNG

Not asked - Allowed

Not asked - allowed

Graded

Not asked - Allowed

Not asked - Allowed

Not asked - Allowed

BLOOD CLOTS

See Stent and check Med List

Not asked - Ask clients questions about Stents

or Heart Surgery

BLOOD DISORDER POLYCYTHEMIA,

THROMBOCYTOPENIA, HEMOPHILIA COAGULATION

DISORDERS

Not asked - Allowed

Not asked

BONE MARROW TRANSPLANT Not asked - Allowed

DECLINE

See Stent

Surgical procedure within 2 yrs - ROP; Within

3 years - Graded

See Stent

Graded

See Blood Clotting

Not asked

DECLINE

Not asked - Allowed

DECLINE

See Stent Not asked - Allowed

DECLINE

BRONCHITIS (CHRONIC)

Not asked - Check inhalers/meds

Standard

Not asked - Check inhalers / meds

Treated within 2 yrs ROP;

Within 3 years - Graded

Not asked - Check inhalers/meds

Graded

CANCER (OTHER THAN BASAL CELL)

Metastatic / Recurrent DECLINE;

w/in 2 yrs - Guaranteed Issue; > 2 years - allowed

Current OR treated within 2 years OR recurring - DECLINE; Basal cell and Squamous - Preferred; >2 yrs -

Preferred

Reoccuring or current DECLINE; within 3 years -

Modif ied

Current - DECLINE; Reoccurring / w/in 2 yrs -

ROP; Within 3 years - Graded

Current - DECLINE; Diagnosed or treated within 3 years - Basic

4 years - allowed

FINAL EXPENSE GRID SHEET

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ILLNESS / CONDITION

EAGLE PREMIER

CEREBRAL PALSY

Not asked - Allowed

ACCENDO DECLINE

NEW VISTA Not asked - Allowed

SENIOR CHOICE

Diagnosed or Treated within 3 yrs - Graded

PLAN RIGHT Not asked - Allowed

LIVING PROMISE Not asked - Allowed

CHRONIC PAIN (6 OR MORE FILLS OF NARCOTIC PAIN PRESCRIPTIONS)

Check Med List

Check Meds

Check Med List

Check Med List - See Neuropathy

Check Meds

Check Med List

CIRRHOSIS

Guaranteed Issue

Treated within 2 years Modif ied

Stage C - DECLINE; Stage A or B - Graded

Treated within 2 yrs ROP;

Within 3 years - Graded

CONGESTIVE HEART FAILURE / HEART FAILURE DIASTOLIC HEART FAILURE

Guaranteed Issue

DECLINE

Within 2 years Modif ied

DECLINE

Standard DECLINE

DECLINE DECLINE

CORONARY ARTERY DISEASE

within 1 yr - Guaranteed Issue

See Heart Disease

COPD

Guaranteed Issue

Standard

See Heart Disease

ROP

Graded

Treated within 2 yrs ROP;

Within 3 years - Graded; > 3 yrs - Immediate

See Heart Disease Standard

Within 1 yr - DECLINE; Within 2 yrs - Graded

Graded

CROHN'S DISEASE

Allowed

Not asked

Not asked - Allowed

Not asked - Allowed

Not asked - Allowed

Not asked - Allowed

CYSTIC FIBROSIS

Guaranteed

DECLINE

Not asked - Allowed

Not asked - Allowed

Not asked

Graded

DEMENTIA

Guaranteed Issue

DECLINE

DECLINE

DECLINE

DECLINE

DECLINE

FINAL EXPENSE GRID SHEET

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ILLNESS / CONDITION

DEPRESSION

EAGLE PREMIER Not asked - Allowed

ACCENDO Not asked

NEW VISTA If Bipolar - Graded

SENIOR CHOICE Not asked - Allowed

PLAN RIGHT Not asked

LIVING PROMISE

Bipolar within 4 years Graded

DIABETES

Allowed - See Diabetic Complications

Allowed - See Diabetic Complications

Allowed - See Diabetic Complications

Insulin prior to age 50ROP; otherwise -

immediate (see Diabetic Complications)

Allowed - See Diabetic Complications

Diagnosed / treated prior to age 50 - Graded (see diabetic complications)

DIABETIC COMPLICATIONS (INSULIN SHOCK, COMA,

RETINOPATHY, NEPHROPATHY, NEUROPATHY)

within 2 yrs - Guaranteed Issue

Amputation - DECLINE: Diabetic Coma, Insulin

Shock, Neuropathy, Nephropathy,

Retinopathy - Modified

Insulin Shock, diabetic coma, or amputation -

Modified; All other complications - Preferred

Diagnosed/treated for complications - ROP

Insulin Shock, diabetic coma, or amputation DECLINE: Neuropathy, PVD/PAD, Retinopathy -

Basic

Insulin shock, diabetic coma - DECLINE; Retinopathy, Nephropathy,

Neuropathy - Graded

DIALYSIS

Kidney Dialysis Guaranteed Issue

Within 1 year - DECLINE

DECLINE

DECLINE

Within 1 year - DECLINE

DECLINE

DOWN'S SYNDROME

Not asked - Allowed

See Mental Incapacity

Graded

See Mental Incapacity

Not asked

DECLINE

DUI

Not asked - Allowed

EMPHYSEMA (CHRONIC)

Guaranteed Issue

EPILEPSY/SEIZURES

Not asked - Allowed

Within 2 years Modif ied

Standard

Not asked

Within 2 years Modif ied

Graded

Not asked - allowed

Treated within 2 yrs ROP;

Within 3 years - Graded

Not asked - Allowed

Within 3 years - Graded

Within 2 years Standard Not asked

Not asked - allowed Graded

Not asked - Allowed

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ILLNESS / CONDITION

FELONY

EAGLE PREMIER

within 6 months Guaranteed Issue

ACCENDO Not asked

NEW VISTA Not asked

SENIOR CHOICE Not asked - Allowed

PLAN RIGHT Not asked

LIVING PROMISE

Convicted within 2 years or awaiting trial - Graded

HEART ATTACK

within 1 yr - Guaranteed Issue

Within 1 year - Modified; Between 1- 2 years Standard; > 2 yrsPreferred

HEART SURGERY

within 1 yr - Guaranteed Issue

Within 1 year - Modified; Between 1- 2 years Standard; > 2 yrsPreferred

HEART VALVE REPLACEMENT

within 1 yr - Guaranteed Issue

Within 1 year - Modified; Between 1- 2 years Standard; > 2 yrsPreferred

Within 2 years Modif ied

Within 2 years Modif ied

Within 2 years Modif ied

Within 2 yrs - ROP; Within 3 yrs - Graded

Within 1 year - Basic;

Within 1 yr - DECLINE;

within 2 year - Standard Within 2 yrs - Graded

Within 2 yrs - ROP; Within 3 yrs - Graded

Within 1 year - Basic;

Within 1 yr - DECLINE;

within 2 year - Standard Within 2 yrs - Graded

Within 2 yrs - ROP; Within 3 yrs - Graded

Within 1 year - Basic;

Within 1 yr - DECLINE;

within 2 year - Standard Within 2 yrs - Graded

HEPATITIS A

Allowed

Within 2 years - Modified

Chronic or current Graded

Chronic or treated within 2 yrs - ROP

Not asked

Not asked - Allowed

HEPATITIS B HEPATITIS C

Guaranteed Issue

Within 2 years - Modified

Chronic or current Graded

Chronic or treated within 2 yrs - ROP

Guaranteed Issue

Within 2 years - Modified

Chronic or current Graded

Chronic or treated within 2 yrs - ROP; within 3 yrs -

Graded

Standard Standard

Not asked - Allowed Graded

HUNTINGTON'S DISEASE

Not asked - Allowed

DECLINE

Not asked

Not asked - Allowed

Not asked

DECLINE

IRREGULAR HEARTBEAT

Not asked - Allowed

Not asked - allowed

Not asked - Allowed

Not asked - Allowed

Not asked - Allowed

Within 2 yrs - Graded

FINAL EXPENSE GRID SHEET

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ILLNESS / CONDITION

ILLEGAL DRUGS

EAGLE PREMIER

ACCENDO

within 2 yrs - Guaranteed Treatment within the past 2

Issue

years ? Modified

NEW VISTA See Felony or DUI

SENIOR CHOICE

PLAN RIGHT

Used within 2 years - ROP

Within 2 years - Basic

LIVING PROMISE within 2 yrs - Graded

JAIL / INCARCERATED

DECLINE

Not asked

Not asked

DECLINE

Not asked

DECLINE

KIDNEY DISEASE / DISORDER / FAILURE (ALSO SEE DIALYSIS)

Chronic - Guaranteed Issue

Graded (also see dialysis)

Graded (also see dialysis) Dialysis - DECLINE; Failure Standard (also ask about

or Disease - ROP;

dialysis)

DECLINE

LIVER DISEASE

Guaranteed Issue

Graded

Graded

Liver failure - DECLINE; Live disease within 3 yrs Graded

Standard

Cirrhosis - DECLINE

LUPUS (SYSTEMIC LUPUS ERYTHEMATOSUS)

Not asked - Allowed

Graded

Graded

Treated / Diagnosed within 2 yrs - ROP

Standard

Within 4 yrs + Systemic Graded

MELANOMA

MENTAL INCAPACITY / RETARDATION

Malignant - DECLINE

Within 3 years - Modified (but excludes basal /

squamous cell skin cancer)

Within 3 years - Modified (but excludes basal /

squamous cell skin cancer)

Not asked - Allowed

Graded

Graded

See Cancer DECLINE

Basal cell - Preferred; otherwise see cancer

Within 2 yrs - DECLINE; Within 4 yrs - Graded

Not asked

Not asked - Allowed

MULTIPLE SCLEROSIS (MS)

Not asked - Allowed

Not asked

Not asked

Diagnosed / treated within 3 yrs - Graded

Preferred

Within 4 yrs - Graded

NEUROPATHY

Due to Diabetes / treated

w/in 2 yrs - Guarantee Issue; Not associated with diabetes - See med

Due to diabetes - Modified; Otherwise ok

list

See diabetic complications

Due to diabetes prior to age 50 - ROP;

Not due to diabetes Immediate

Due to diabetes - Basic; Otherwise ok

Due to diabetes prior to age 50 - Graded; Not due

to diabetes - allowed

OXYGEN

w/in 6 mos - Guaranteed

Within 1 year - DECLINE (CPAP OK)

DECLINE

DECLINE

Within 1 year - DECLINE

DECLINE

FINAL EXPENSE GRID SHEET

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ILLNESS / CONDITION

EAGLE PREMIER

ACCENDO

PACEMAKER / DEFIBRILLATOR IMPLANT

within 1 yr - Guaranteed Issue

Within 1 year - Modified; Between 1- 2 years Standard; > 2 yrsPreferred

NEW VISTA

Within 2 years Modif ied

SENIOR CHOICE

PLAN RIGHT

LIVING PROMISE

Received within 2 years ROP; Received within 3

years - Graded

Implanted within 1 year Basic; within 2 years -

Standard; Over 2 years Preferred

Not specifically asked but check meds / heart conditions - could be Graded

PANCREATITIS

Not asked - Allowed

PARKINSON'S DISEASE

Allowed

PAROLE / PROBATION (CURRENTLY)

within 6 months Guaranteed Issue

Not asked Standard Not asked

Not asked - Allowed

Chronic / treated within 2 yrs - ROP

Not asked

Not asked - Allowed

Graded

Treated / diagnosed within 3 yrs - Graded

Standard if able to perform all activities of daily living - Otherwise

DECLINE

Within 4 yrs - Graded

Not asked

Not asked

Not asked

2 yrs convicted or awaiting trial - Graded

PAD / PVD

Not asked - allowed

Not asked

Not asked

Not asked - Allowed

See Diabetic complication

Graded

PTSD

Allowed

Not asked

Not asked

Not asked - Allowed

Not asked

Not asked - Allowed

PULMONARY FIBROSIS

Ask about oxygen

RHEUMATOID ARTHRITIS SARCOIDOSIS

SCHIZOPHRENIA

Not asked - Allowed Not asked - Allowed

Allowed

DECLINE Not asked Not asked Preferred

Ask about oxygen

Ask about oxygen

Ask about oxygen

Ask about oxygen

Not asked Not asked

Graded

Not asked - Allowed Not asked - Allowed Not asked - Allowed

Not asked Not asked Preferred

Not asked - Allowed

Graded

Treated/diagnosed within 4 yrs - Graded

FINAL EXPENSE GRID SHEET

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ILLNESS / CONDITION

SEIZURES

EAGLE PREMIER Allowed

ACCENDO Not asked

NEW VISTA Not asked - allowed

SENIOR CHOICE Within 3 years - Graded

PLAN RIGHT Not asked

LIVING PROMISE Not asked - allowed

SICKLE CELL ANEMIA

Allowed

DECLINE

Graded

Not asked - allowed

Not asked

DECLINE

SLEEP APNEA

Not asked - Allowed

Not asked

Not asked

See Oxygen Use

Not asked

Graded

STENT

within 1 yr - Guaranteed Issue

Not asked - See Heart Surgery

Within 2 years Modif ied

Within 2 yrs - ROP; Within 3 yrs - Graded

Within 1 year - Basic;

Within 1 yr - DECLINE;

within 2 year - Standard Within 2 yrs - Graded

STROKE / TIA ATTACK

Within 1 yr Guaranteed Issue TIA - Not asked -

allowed

Within 1 year - Modified; Between 1- 2 years Standard; > 2 yrsPreferred

Within 2 years Modif ied

Stroke or TIA within 2 yrs - ROP; Stroke within 3 years - Graded

Within 1 year - Basic; within 2 year - Standard

Within 2 yrs - Graded

TERMINAL ILLNESS

Death within 2 yrs DECLINE

DECLINE

DECLINE

Death in the next 12 months - DECLINE

DECLINE

Death in the next 12 months- DECLINE

ORGAN TRANSPLANT

Guaranteed Issue

DECLINE

DECLINE

DECLINE

DECLINE

DECLINE

TUBERCULOSIS

Not asked - Allowed

Not asked

Graded

Not asked - Allowed

Not asked

Not asked - Allowed

ULCERATIVE COLITIS

Not asked - Allowed

Not asked

Not asked - Allowed

within 3 years - Graded

Not asked

Not asked - Allowed

WALKER

WHEELCHAIR / ELECTRIC SCOOTER / ELECTRIC CART

within 6 mos Guaranteed Issue

within 6 months Guaranteed Issue

Not asked

Use Wheelchair or scooter - DECLINE

Not asked

Not asked

Not asked

Not asked

Confined or due to diabetes- DECLINE

Due to Illness or Disease DECLINE

Confined or due to diabetes - DECLINE

Due to Illness or Disease DECLINE

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