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M3111-3 rdtd pharmacy guide:layout 1.qxd

Rapid Decision Term Table D Underwriting (Using Rapid App 2 only)
Pharmacy Guidelines for Agents

If medications for these conditions are taken
Acceptable Medications (Okay to submit)
in past 10 yrs, DO NOT TAKE APPLICATION
Anti-Psychotics—Schizophrenia, etc.
Anxiety/Depression treated by psychiatristAutism Narcotic Pain Medications (Opiates)
➤ Short term use in past 5 years with details Cancer—Hodgkins, Leukemia, LymphomaCardio Vascular Disease ➤ Individual consideration if taken long term or continu- Congestive Heart Failure or Cardiomyopathy ously (Percocet, Vicodin, Oxycontin, Oxycodone, etc.) COPD—chronic pulmonary diseaseCoronary Artery Disease Non-Narcotic Pain Medications
➤ If taken long term or continuously, need details Prednisone
➤ Usually prescribed for allergric disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis or breathing Organ Transplants or Valve ReplacementsPancreatitisPeripheral Vascular Disease ➣ If currently taking for Asthma—decline Rheumatoid Arthritis—on Disability or steroids ➣ If taken within past 5 years, interview for details and if Severe Muscle Disorders, i.e. Multiple Sclerosis not on regular basis, Standard applies.
Seizure—Grand Mal DisorderSleep Apnea—severe or under age 50 ➣ If taken over 5 years, not continuously, okay Standard * If long term/continual use, o/w call for details ➣ If taken for any other impairment, obtain details! All of the above medications are okay individually, but if taken
with other medications or there are underlying conditions,
obtain details and/or call Underwriting.

Note: This is only a GUIDE, it is not all-inclusive.
Top Drugs by Prescriptions Dispensed (A-L)
Key: For Underwriting Rapid Decision Term Table D Products (Using Rapid App 2 only)
A: Individual medications okay to submit
B: Medications taken within past 10 years, interview for details*
C: Medications we will not accept if taken within past 10 years
* unless adequate details are provided on the app
Drug Name
Common Uses or Type of Drug
Drug Name
Key Common Uses or Type of Drug
** Interview if short term use, if taken long-term or continuously, decline.
Top Drugs by Prescriptions Dispensed (L-Z)
Key: For Underwriting Rapid Decision Term Table D Products (Using Rapid App 2 only)
A: Individual medications okay to submit
B: Medications taken within past 10 years, interview for details*
C: Medications we will not accept if taken within past 10 years
* unless adequate details are provided on the app
Drug Name
Common Uses or Type of Drug
Drug Name
Common Uses or Type of Drug
** Interview if short term use, if taken long-term or continuosly, decline.

Source: http://www.fla-life.com/agents/pdfs/rdTerm/M3111_3RDTD%20PharmacyGuide.pdf

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