Carrier: Occidental/American Amicable (AmAm)
Product: Home Protector Term
Product Types: 15, 20, and 30-Year Simplified Issue Term
Issue Ages: Varies by term and band (18–65 overall)
Face Amounts: $25,000–$500,000 (banded pricing structure)
Target Market: Mortgage protection or income replacement with simplified underwriting; includes built-in living benefits and optional return-of-premium
Carrier
Occidental Life Insurance Company of North Carolina (a member of the American-Amicable Group)
Product Overview
Home Protector is a simplified issue level term life insurance product providing coverage to age 95. It is available in 15, 20, 25, and 30-year level premium options, with Return of Premium (ROP) available on the 20-, 25-, and 30-year terms. Premiums remain level during the selected term and coverage is renewable after the level period ends. This plan is designed to offer fast, simplified underwriting decisions and includes several built-in and optional riders.
Issue Ages and Face Amounts
- 15-Year Term: Ages 20–65
- 20-Year Term: Ages 20–60
- 25-Year Term: Ages 20–55
- 30-Year Term: Ages 20–50
- 20-Year ROP: Ages 20–60
- 25-Year ROP: Ages 20–55
- 30-Year ROP: Ages 20–50
- Minimum Face: $25,000 or $25 monthly premium (excluding riders)
- Maximum Face: $500,000 (ages 20–45), $300,000 (ages 46–65)
Underwriting Guidelines
Home Protector uses simplified issue underwriting. Policies are issued Standard through Table 4. There are no table ratings above Table 4. Eligibility is determined by application responses, MIB, prescription database, and optional telephone interview. Applicants exceeding weight/build chart limits or taking medications with disqualifying flags will be declined. APS (Attending Physician Statements) may be requested. A current mortgage is required for all applicants.
Build Chart
Applicants must fall within the acceptable range in the chart below. Applicants below minimum or above maximum are declined.
BUILD CHART | BUILD CHART | BUILD CHART | BUILD CHART |
---|---|---|---|
HEIGHT | MINIMUM WEIGHT MUST BE AT LEAST | MAXIMUM WEIGHT WITHIN TABLE 2 | MAXIMUM WEIGHT WITHIN TABLE 4 |
4’10” | 86 | 182 | 199 |
4’11” | 88 | 188 | 205 |
5’ | 90 | 195 | 212 |
5’1” | 93 | 201 | 220 |
5’2” | 95 | 208 | 227 |
5’3” | 99 | 215 | 234 |
5’4” | 101 | 221 | 242 |
5’5” | 104 | 228 | 249 |
5’6” | 106 | 235 | 257 |
5’7” | 110 | 243 | 265 |
5’8” | 113 | 250 | 273 |
5’9” | 117 | 257 | 281 |
5’10” | 120 | 265 | 289 |
5’11” | 125 | 272 | 298 |
6’ | 129 | 280 | 306 |
6’1” | 133 | 288 | 315 |
6’2” | 136 | 296 | 323 |
6’3” | 140 | 304 | 332 |
6’4” | 143 | 312 | 341 |
6’5” | 146 | 320 | 350 |
6’6” | 149 | 329 | 359 |
6’7” | 153 | 337 | 368 |
6’8” | 157 | 346 | 378 |
6’9” | 160 | 355 | 387 |
Medical Impairment Guide
The impairment guide outlines insurability based on specific medical conditions. Decisions reflect eligibility for the base plan, Disability Riders, AODIR, and Critical Illness Rider. Use the guide to identify automatic declines and conditions requiring special underwriting.
EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) | EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) | EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) | EASY TERM PRESCRIPTION REFERENCE GUIDE (continued) |
---|---|---|---|
Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. | Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. | Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. | Where medications used for more than one condition exist, alternate uses and appropriate levels of coverage are listed below. Suppose the insured had a medication prescribed within a time frame in the ‘RX FILL WITHIN’ column. For those conditions, the time frame impacts the Underwriting decision. If `N/A’ appears in this column, then the Underwriting decision will be the same regardless of when the insured filled the prescription. |
MEDICATION | COMMON USE OF CONCERN | RX FILL WITHIN | PLAN ELIGIBILITY |
Betapace | Heart Arrhythmia | N/A | Decline |
Betapace | CHF | N/A | Decline |
Betaseron | Multiple Sclerosis | N/A | Decline |
Betaxolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Betaxolol HCL | CHF | N/A | Decline |
BiDil | CHF | N/A | Decline |
Bisoprolol Fumarate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Bisoprolol Fumarate | CHF | N/A | Decline |
Bromocriptine Mesylate | Parkinson’s | N/A | Decline |
Bumetanide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Bumetanide | CHF | N/A | Decline |
Bumex | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Bumex | CHF | N/A | Decline |
Buprenex | Alcohol / Drugs | 4 years | Decline |
Bystolic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Bystolic | CHF | N/A | Decline |
Calan | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Calcium Acetate | Kidney Dialysis | N/A | Decline |
Calcium Acetate | Renal Insufficiency/Failure | N/A | Decline |
Calcium Acetate | Diabetic Nephropathy | N/A | Decline |
Campath | Cancer | 8 years > 8 years | Decline Standard |
Campral | Alcohol / Drugs | 4 years | Decline |
Capoten | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Capoten | CHF | N/A | Decline |
Capozide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Capozide | CHF | N/A | Decline |
Captopril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Captopril | CHF | N/A | Decline |
Carbamazepine | Seizures | N/A | See Impairment Guide |
Carbatrol | Seizures | N/A | See Impairment Guide |
Carbidopa | Parkinson’s | N/A | Decline |
Cardizem | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Cardura | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Cartia | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Carvedilol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Carvedilol | CHF | N/A | Decline |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Prescription Medication Guide
This table lists medications that impact eligibility. Plan decisions are based on medication use, diagnosis, and timing. Conditions marked with ‘N/A’ apply regardless of prescription timing. See footnotes for high blood pressure and diabetes-specific considerations.
Medication | Use | RX Fill Within | Plan Eligibility |
---|---|---|---|
Digoxin | Irregular Heartbeat | N/A | Decline |
Digoxin | CHF | N/A | Decline |
Dilacor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Dilantin | Seizures | N/A | See Impairment Guide |
Dilatrate SR | Angina / CHF | N/A | Decline |
Dilor | Asthma | N/A | See Impairment Guide |
Dilor | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Diovan | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Diovan | CHF | N/A | Decline |
Disulfiram | Alcohol / Drugs | 4 years | Decline |
Dolophine | Opioid Dependence | 4 years | Decline |
Donepezil HCL | Alzheimer’s / Dementia | N/A | Decline |
Duoneb | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Dyazide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Dyazide | CHF | N/A | Decline |
Dynacirc | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Dyrenium | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Dyrenium | CHF | N/A | Decline |
Edecrin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Edecrin | CHF | N/A | Decline |
Edurant | AIDS | N/A | Decline |
Eldepryl | Parkinson’s | N/A | Decline |
Emtriva | AIDS | N/A | Decline |
Enalapril Maleate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Enalapril Maleate | CHF | N/A | Decline |
Enalaprilat | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Enalaprilat | CHF | N/A | Decline |
Epitol | Seizures | N/A | See Impairment Guide |
Epivir | AIDS | N/A | Decline |
Eplerenone | CHF | N/A | Decline |
Eskalith | Bi-Polar / Schizophrenia | N/A | Decline |
Esmolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Esmolol HCL | CHF | N/A | Decline |
Exforge | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Exforge | CHF | N/A | Decline |
Felodipine | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Femara | Cancer | 8 years > 8 years | Decline Standard |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Foscavir | AIDS | N/A | Decline |
Fosinopril Sodium | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Fosinopril Sodium | CHF | N/A | Decline |
Fosrenol | Kidney Dialysis | N/A | Decline |
Fosrenol | Renal Insufficiency / Failure | N/A | Decline |
Fosrenol | Diabetic Nephropathy | N/A | Decline |
Furosemide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Furosemide | CHF | N/A | Decline |
Gabapentin | Seizures | N/A | See Impairment Guide |
Gabapentin | Restless Leg Syndrome | N/A | Standard |
Gleevec | Cancer | 8 years > 8 years | Decline Standard |
Glipizide | Diabetes | N/A | See ‘#’ Below |
Glucophage | Diabetes | N/A | See ‘#’ Below |
Glucotrol | Diabetes | N/A | See ‘#’ Below |
Glyburide | Diabetes | N/A | See ‘#’ Below |
Glynase | Diabetes | N/A | See ‘#’ Below |
Haldol | Schizophrenia | N/A | Decline |
Haloperidol | Schizophrenia | N/A | Decline |
HCTZ/Triamterene | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
HCTZ/Triamterene | CHF | N/A | Decline |
Hectoral | Kidney Dialysis | N/A | Decline |
Hectoral | Renal Insufficiency / Failure | N/A | Decline |
Hectoral | Diabetic Nephropathy | N/A | Decline |
Heparin | Blood Clot / Deep Vein Thrombosis | N/A | See Impairment Guide |
Hepsera | Liver Disorder / Hepatitis | N/A | Decline |
Hizentra | Immunodeficiency | N/A | Decline |
Humalog | Diabetes | N/A | Decline |
Humulin | Diabetes | N/A | Decline |
Hydralazine HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Hydralazine HCL | CHF | N/A | Decline |
Hydroxychloroquine | Systemic Lupus (SLE) | N/A | Decline |
Hydroxychloroquine | Rheumatoid Arthritis | N/A | Decline |
Hydroxyurea | Cancer | 8 years > 8 years | Decline Standard |
Hytrin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Hyzaar | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Hyzaar | CHF | N/A | Decline |
Imdur | Angina / CHF | N/A | Decline |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Imuran | Organ / Tissue Transplant | N/A | Decline |
Imuran | Rheumatoid Arthritis | N/A | Decline |
Imuran | Systemic Lupus (SLE) | N/A | Decline |
Inamrinone | CHF | N/A | Decline |
Inderal | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Inderal | CHF | N/A | Decline |
Inderide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Inderide | CHF | N/A | Decline |
Inspra | CHF | N/A | Decline |
Insulin | Diabetes | N/A | Decline |
Intron-A | Cancer | 8 years > 8 years | Decline Standard |
Intron-A | Hepatitis C | N/A | Decline |
Invirase | AIDS | N/A | Decline |
Ipratropium Bromide | Allergies | N/A | Standard |
Ipratropium Bromide | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Isoptin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Isordil | Angina / CHF | N/A | Decline |
Isosorbide Dinitrate/ Mononitrate | Angina / CHF | N/A | Decline |
Janumet | Diabetes | N/A | See ‘#’ Below |
Januvia | Diabetes | N/A | See ‘#’ Below |
Kaletra | AIDS | N/A | Decline |
Kemadrin | Parkinson’s | N/A | Decline |
Kerlone | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Kerlone | Glaucoma | N/A | Standard |
Labetalol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Labetalol | Angina | N/A | Decline |
Lamictal | Seizures | N/A | See Impairment Guide |
Lamictal | Bi-polar / Major depression | N/A | Decline |
Lamotrigine | Seizures | N/A | See Impairment Guide |
Lamotrigine | Bi-polar / Major depression | N/A | Decline |
Lanoxicaps | Irregular Heartbeat | N/A | Decline |
Lanoxicaps | CHF | N/A | Decline |
Lanoxin | Irregular Heartbeat | N/A | Decline |
Lanoxin | CHF | N/A | Decline |
Lantus | Diabetes | N/A | Decline |
Larodopa | Parkinson’s | N/A | Decline |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Lasix | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Lasix | CHF | N/A | Decline |
Leukeran | Cancer | 8 years > 8 years | Decline Standard |
Levatol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Levatol | Angina | N/A | Decline |
Levemir | Diabetes | N/A | Decline |
Levocarnitine | Kidney Dialysis | N/A | Decline |
Levocarnitine | Renal Insufficiency / Failure | N/A | Decline |
Levocarnitine | Diabetic Nephropathy | N/A | Decline |
Levodopa | Parkinson’s | N/A | Decline |
Lexiva | AIDS | N/A | Decline |
Lipitor | Cholesterol | N/A | Standard |
Lisinopril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Lisinopril | CHF | N/A | Decline |
Lithium | Bi-Polar / Schizophrenia | N/A | Decline |
Lodosyn | Parkinson’s | N/A | Decline |
Lopressor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Losartan | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Losartan | CHF | N/A | Decline |
Lotensin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Lotensin | CHF | N/A | Decline |
Loxapine | Schizophrenia | N/A | Decline |
Loxitane | Schizophrenia | N/A | Decline |
Lozol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Lupron | Cancer | 8 years > 8 years | Decline Standard |
Lyrica | Seizures | N/A | See Impairment Guide |
Mavik | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Mavik | CHF | N/A | Decline |
Maxzide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Maxzide | CHF | N/A | Decline |
Mellaril | Schizophrenia | N/A | Decline |
Metformin | Diabetes | N/A | See ‘#’ Below |
Methadone | Opioid Dependence | 4 years | Decline |
Methadose | Opioid Dependence | 4 years | Decline |
Methotrexate | Cancer | 8 years > 8 years | Decline Standard |
Methotrexate | Rheumatoid Arthritis | N/A | Decline |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Metoprolol HCTZ | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Metoprolol HCTZ | CHF | N/A | Decline |
Metoprolol Tartrate / Succinate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Metoprolol Tartrate / Succinate | CHF | N/A | Decline |
Micardis | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Micardis | CHF | N/A | Decline |
Micronase | Diabetes | N/A | See ‘#’ Below |
Milrinone | CHF / Cardiomyopathy | N/A | Decline |
Minipress | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Minitran | Angina / CHF | N/A | Decline |
Mirapex | Parkinson’s | N/A | Decline |
Mirapex | Other Use | N/A | Standard |
Moban | Schizophrenia | N/A | Decline |
Moduretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Moduretic | CHF | N/A | Decline |
Moexipril HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Moexipril HCL | CHF | N/A | Decline |
Monoket | Angina / CHF | N/A | Decline |
Monopril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Monopril | CHF | N/A | Decline |
Mysoline | Seizures | N/A | See Impairment Guide |
Nadolol | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Nadolol | CHF | N/A | Decline |
Naloxone | Alcohol / Drugs | 4 years | Decline |
Naltrexone | Alcohol / Drugs | 4 years | Decline |
Narcan | Alcohol / Drugs | 4 years | Decline |
Natrecor | CHF | N/A | Decline |
Navane | Schizophrenia | N/A | Decline |
Neurontin | Seizures | N/A | See Impairment Guide |
Nifedipine | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Nimodipine | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
Nimotop | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
Nitrek | Angina / CHF | N/A | Decline |
Nitro-bid | Angina / CHF | N/A | Decline |
Nitro-dur | Angina / CHF | N/A | Decline |
Nitroglycerine / Nitrotab / Nitroquick/Nitrostat | Angina / CHF | N/A | Decline |
Nitrol | Angina / CHF | N/A | Decline |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Normodyne | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Norpace | Irregular Heartbeat | N/A | Decline |
Norvir | AIDS | N/A | Decline |
Novolin | Diabetes | N/A | Decline |
Novolog | Diabetes | N/A | Decline |
Pacerone | Irregular Heartbeat | N/A | Decline |
Pancrease | Chronic Pancreatitis | N/A | Decline |
Parcopa | Parkinson’s | N/A | Decline |
Parlodel | Parkinson’s | N/A | Decline |
Pegasys | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
Peg-Intron | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
Pentam 300 | AIDS | N/A | Decline |
Pentamidine Isethionate | AIDS | N/A | Decline |
Pergolide Mesylate | Parkinson’s | N/A | Decline |
Permax | Parkinson’s | N/A | Decline |
Phenobarbital | Seizures | N/A | See Impairment Guide |
Phoslo | Kidney Dialysis | N/A | Decline |
Phoslo | Renal Insufficiency / Failure | N/A | Decline |
Phoslo | Diabetic Nephropathy | N/A | Decline |
Plaquenil | Systemic Lupus (SLE) | N/A | Decline |
Plaquenil | Malaria | N/A | Standard |
Plaquenil | Rheumatoid Arthritis | N/A | Decline |
Plavix | Stroke / Heart or Circulatory Disease or Disorder | N/A | Decline |
Plendil | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Prandin | Diabetes | N/A | See ‘#’ Below |
Prazosin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Primacor | CHF | N/A | Decline |
Prinivil | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Prinivil | CHF | N/A | Decline |
Prinzide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Prinzide | CHF | N/A | Decline |
Procardia | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Prograf | Organ / Tissue Transplant | N/A | Decline |
Proleukin | Cancer | 8 years > 8 years | Decline Standard |
Prolixin | Schizophrenia | N/A | Decline |
Propranolol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Propranolol HCL | CHF | N/A | Decline |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Proventil | Asthma | N/A | See Impairment Guide |
Proventil | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Prozac | Depressive Disorder | N/A | Standard |
Quinapril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Quinapril | CHF | N/A | Decline |
Quinaretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Quinaretic | CHF | N/A | Decline |
Ramipril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Ramipril | CHF | N/A | Decline |
Ranexa | Angina / CHF | N/A | Decline |
Rapamune | Organ / Tissue Transplant | N/A | Decline |
Rebetol | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
Rebetron | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
Rebif | Multiple Sclerosis | N/A | Decline |
Renagel | Kidney Dialysis | N/A | Decline |
Renagel | Renal Insufficiency / Failure | N/A | Decline |
Renagel | Diabetic Nephropathy | N/A | Decline |
Renvela | Kidney Dialysis | N/A | Decline |
Renvela | Renal Insufficiency / Failure | N/A | Decline |
Renvela | Diabetic Nephropathy | N/A | Decline |
Requip | Parkinson’s | N/A | Decline |
Requip | Restless Leg Syndrome | N/A | Standard |
Ribavirin | Liver Disorder / Hepatitis C / Chronic Hepatitis | N/A | Decline |
Rilutek | ALS / Motor Neuron Disease | N/A | Decline |
Risperdal | Bi-Polar / Schizophrenia | N/A | Decline |
Risperidone | Bi-Polar / Schizophrenia | N/A | Decline |
Rituxan | Cancer | 8 years > 8 years | Decline Standard |
Rituxan | Rheumatoid Arthritis | N/A | Decline |
Ropinirole | Parkinson’s | N/A | Decline |
Ropinirole | Restless Leg Syndrome | N/A | Standard |
Rythmol | Irregular Heartbeat | N/A | Decline |
Serevent | Asthma | N/A | See Impairment Guide |
Serevent | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Seroquel | Bi-Polar / Schizophrenia | N/A | Decline |
Sinemet/Sinemet CR | Parkinson’s | N/A | Decline |
Sodium Edecrin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Sodium Edecrin | CHF | N/A | Decline |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Sotalol Hydrochloride | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Sotalol Hydrochloride | CHF | N/A | Decline |
Sotalol HCL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Sotalol HCL | CHF | N/A | Decline |
Spiriva | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Spironolactone | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Spironolactone | CHF | N/A | Decline |
Sprycel | Cancer | 8 years > 8 years | Decline Standard |
Stalevo | Parkinson’s | N/A | Decline |
Starlix | Diabetes | N/A | See ‘#’ Below |
Suboxone | Alcohol / Drugs | 4 years | Decline |
Subutex | Alcohol / Drugs | 4 years | Decline |
Sustiva | AIDS | N/A | Decline |
Symbicort | Asthma | N/A | Standard |
Symbicort | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Symmetrel | Parkinson’s | N/A | Decline |
Tambocor | Irregular Heartbeat | N/A | Decline |
Tamoxifen | Cancer | 8 years > 8 years | Decline Standard |
Tarka | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Tarka | CHF | N/A | Decline |
Tasmar | Parkinson’s | N/A | Decline |
Tegretol | Seizures | N/A | See Impairment Guide |
Tenex | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Tenoretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Tenoretic | CHF | N/A | Decline |
Tenormin | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Tenormin | CHF | N/A | Decline |
Theo-Dur | Asthma | N/A | See Impairment Guide |
Theo-Dur | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Theophylline | Asthma | N/A | See Impairment Guide |
Theophylline | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Thioridazine | Schizophrenia | N/A | Decline |
Thiothixene | Schizophrenia | N/A | Decline |
Thorazine | Schizophrenia | N/A | Decline |
Tiazac | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Tolazamide | Diabetes | N/A | See ‘#’ Below |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Tolbutamide | Diabetes | N/A | See ‘#’ Below |
Tolinase | Diabetes | N/A | See ‘#’ Below |
Toprol XL | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Toprol XL | CHF | N/A | Decline |
Torsemide | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Torsemide | CHF | N/A | Decline |
Trandate | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Trandate | CHF | N/A | Decline |
Triamterene | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Triamterene | CHF | N/A | Decline |
Tribenzor | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Tribenzor | CHF | N/A | Decline |
Trihexyphenidyl HCL | Parkinson’s | N/A | Decline |
Tresiba (Insulin) | Diabetes | N/A | Decline |
Truvada | AIDS | N/A | Decline |
Tyzeka | Liver Disorder / Hepatitis | N/A | Decline |
Uniretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Uniretic | CHF | N/A | Decline |
Univasc | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Univasc | CHF | N/A | Decline |
Valcyte | AIDS | N/A | Decline |
Valproic Acid | Seizures | N/A | See Impairment Guide |
Valstar | Cancer | 8 years > 8 years | Decline Standard |
Valturna | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Valturna | CHF | N/A | Decline |
Vascor | Angina | N/A | Decline |
Vaseretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Vaseretic | CHF | N/A | Decline |
Vasotec | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Vasotec | CHF | N/A | Decline |
Ventolin | Asthma | N/A | See Impairment Guide |
Ventolin | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Verapamil | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Viaspan | Organ / Tissue Transplant | N/A | Decline |
Viracept | AIDS | N/A | Decline |
Viramune | AIDS | N/A | Decline |
Viread | AIDS | N/A | Decline |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Visken | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Visken | CHF | N/A | Decline |
Vivitrol | Alcohol / Drugs | 4 years | Decline |
Warfarin | Blood Clot / Deep Vein Thrombosis | N/A | See Impairment Guide |
Warfarin | Stroke / Heart or Circulatory Disease or Disorder / Heart Valve Disease | N/A | Decline |
Xeloda | Cancer | 8 years > 8 years | Decline Standard |
Xopenex | Asthma | N/A | See Impairment Guide |
Xopenex | COPD / Emphysema / Chronic Bronchitis | N/A | Decline |
Zelapar | Parkinson’s | N/A | Decline |
Zemplar | Kidney Dialysis | N/A | Decline |
Zemplar | Renal Insufficiency / Failure | N/A | Decline |
Zemplar | Diabetic Nephropathy | N/A | Decline |
Zestoretic | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Zestoretic | CHF | N/A | Decline |
Zestril | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Zestril | CHF | N/A | Decline |
Ziac | High Blood Pressure (HTN) | N/A | See ‘*’ Below |
Ziac | CHF | N/A | Decline |
Zyprexa | Bi-Polar / Schizophrenia | N/A | Decline |
* High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. | * High Blood Pressure - If controlled with 2 or fewer medications, the client could qualify for the plan. If controlled with 3 or more medications, the client will not be eligible for coverage. |
# Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. | # Diabetes - If diagnosed, treated, or taken medication prior to age 35, the client will not be eligible for coverage. If currently taking insulin shots or tobacco use within the past 12 months, the client will not be eligible for coverage. If combined with overweight, gout, retinopathy, or protein in the urine; the client is not eligible for coverage. |
Included Riders (No Additional Cost)
- Terminal Illness Accelerated Death Benefit Rider
- Confined Care Accelerated Benefit Rider
- Chronic Illness Accelerated Death Benefit Rider
Optional Riders
- Critical Illness Rider (25%, 50%, or 100% up to $100,000)
- Total Disability Benefit Rider (2% of face amount, up to $1,500/mo)
- Accident Only Total Disability Rider (up to $2,000/mo)
- Waiver of Premium – Disability
- Waiver of Premium – Unemployment
- Children’s Insurance Agreement (up to 5 units @ $3,000 each)
- Accidental Death Benefit Rider (up to $200,000)
Conversion Options
Non-ROP: Convertible to permanent coverage anytime before the earlier of: policy expiry, age 75, or 5 years from issue date (if issued after age 75).
ROP: Convertible before the end of the level term period or policy anniversary of age 75. No evidence of insurability required.
Eligibility Requirements
- Must have a current mortgage; domestic partners allowed with shared financial interest
- Applicants must reside in the U.S. and have a valid Social Security number
- Third-party payors (outside spouse, business partner, or parent under age 30) are not allowed
- Mobile application decisions include: approved, interview required, home office referral, or decline
- Uninsurable occupations: Blasters, underground miners, casino workers, professional athletes, disabled, unemployed (except students, stay-at-home spouses), and those with risky avocations
Application Notes
- Form No. 3491 must be used (state-specific)
- Submit via mobile app, AppDrop, or fax
- Initial premium accepted via eCheck or bank draft (no money orders)
- Voice, email, or on-device signature allowed via mobile app
- Point-of-sale decisions delivered instantly when using mobile app