All baby boomers need to read this book!
Robert W. Griffith, MD
Editor, HealthandAge.com 

This book is a great gift for a financial advisor to give to all clients with senior parents.
Dick Bell, CLU, ChFC, President 2004 Society of Financial Service Professionals

The news on the state of type 2 diabetes control in the United States is not encouraging according to the American Association of Clinical Endocrinologist (AACE).  Two-thirds of Americans with type 2 diabetes (67%) did not meet the AACE’s target of an A1-C of 6.5% in 2003 and 2004.

The study analyzed A1-C tests in 157,000 people with type 2 diabetes in 39 states and Washington, D.C.  The study showed that over 20% of the people with diabetes have A1-C levels greater than 9% (poor control).

In 2002 diabetes cost about $132 billion with 80% of the money going to treat diabetic complications.

Bottom Line: Underwriting an applicant with type 2 diabetes is based on the degree of diabetic control (the A1-C level) and any evidence of diabetic complications.  Good control is defined as an A1-C of 6.5% or less.  Ask the applicant to find out their last A1-C reading.  This will give you a good indication of the how the case will be assessed.

For older adults, keeping busy is no substitute for regular exercise as a way to preserve mobility.  In a recent a study reported in the Journal of the American Geriatrics Society, researchers contend that walking should be incorporated into elderly adult’s preventative health program.  Compared with exercising men and women, study participants with an inactive lifestyle were about 50% as likely to develop mobility limitations.  Furthermore, among inactive- and active-lifestyle participants, absence of walking was associated with a higher incidence of mobility limitation.

Stents have revolutionized cardiac care in the United States.  Drug-coated stents have been implanted in three million people worldwide.   Both bare-metal and drug-coated stents carry a risk of blood clots post-PTCA.  However, this was always considered a “short-term” problem that could be managed with anticlotting drugs like Plavix or Coumadin.  New evidence is suggesting that drug-coated stents may pose a longer-term risk of blood clots compared to bare-metal stents.  This increased risk is seen 18 month after implantation. Some doctors are troubled by blood clots they are seeing in patients

as long as two years after implanting a drug-coated stent that are both unpredictable and deadly.

Bottom Line: Look for applicants who have drug-coated stents to be on anticlotting medications longer than the current 6 months window.  In some cases this may turn out to be for life. Prolonged anticlotting medications create new problems from an underwriting perspective because these medications carry an additional mortality risk.  In addition, some applicants are resistant to these types of drugs.  Compliance is also a problem due to side effects.

Medication Alert for
Life and LTC Agents

Because of dispensing errors, the Alzheimer’s medication Reminyl has been renamed to Razadyne.

Razadyne’s Pharmacy Tutor code is RED (underwriting problems).

Bottom Line: If an applicant is taking Razadyne, you need to determine the severity and progression of the underlying dementia (i.e. Alzheimer's disease).  It is important to obtain the degree of cognitive and memory impairment as well as the impact of this medication on improving these impairments.  Some older applicants with early Alzheimer’s disease are insurable for individual coverage.

Female 82, Non-smoker, $10,000,000 Individual Coverage
Height 5’ 3”, Weight 137 lbs
Current Medications: Lipitor, Aleve

The applicant was postponed for life insurance due a recent fall noted in her medical record.  The clinical note stated she fell and hit her head and was complaining of a headache.  A follow-up chart note three weeks later made no mention of the fall.  The underwriter requested a full gait evaluation and neurological assessment.

Discussion: The applicant and her family felt the request for the two evaluations was excessive and an overreaction to the fall.  Instead, the agent drafted a letter that put the fall into context.  The applicant was at social gathering in a home she was visiting for the first time.  There were two small and unfamiliar steps between the living room and dining room.  The applicant missed the second step and fell hitting her head on a carpeted floor.  She did not lose consciousness and was helped back to her feet immediately.  The agent had the client sign the clarification statement.  In addition, he requested that the carrier conduct another telephone interview with the client to discuss the fall.  The carrier accepted the client’s statement, did a second telephone interview and issued the case at standard rates.