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Pre-Qualification Checklist - Brighthouse Financial - pre qualify one main financial


Pre-Qualification Checklist - Brighthouse Financial-pre qualify one main financial

LIFE INSURANCE | INDEXED UNIVERSAL WITH LONG-TERM CARE
PROVIDED BY RIDERS
Brighthouse SmartCare?
Pre-Qualification
Questionnaire
This questionnaire helps identify who may be a good candidate
for Brighthouse SmartCare?. The proposed insured should
be a permanent resident of the United States.
If the proposed insured answers YES to any of these questions,
they will not qualify for Brighthouse SmartCare.
Blood Are you currently seeing a hematologist for any blood disorders?
Brain Have you had a cognitive disorder, including Alzheimer's disease, dementia, or
memory loss?
Have you had a seizure disorder resulting in two or more seizures a year, or have you
been diagnosed with a seizure disorder in the last 12 months?
Have you had more than one mini-stroke or transient ischemic attack (TIA)?
Brain/ Have you consulted with a medical professional or been treated for any neurological
Nervous disorder related to the following: stroke, Parkinson's disease, multiple sclerosis (MS),
System muscular dystrophy, ALS/Lou Gehrig's disease, or Huntington's disease?
Build See Height and Weight Guide.
Cancer Have you completed cancer treatment in the past 3 years? (Please note that certain skin
cancers, breast cancers, and prostate cancers may qualify within 6 months of treatment.)
Have you been told you had high stage cancer (stage 3 or stage 4)?
Have you received chemotherapy or a bone marrow transplant, or have you had cancer
more than one time?
Diabetes Are you currently using insulin, or been diagnosed with insulin-dependent diabetes?
Gastro Have you been diagnosed with Crohn's disease or ulcerative colitis, and not had a
colonoscopy in the last 3 years?
If the proposed insured answers YES to any of these questions,
they will not qualify for Brighthouse SmartCare.
General Disqualifying Prescription Medications: See Decline Medications List.
Medical Have you been scheduled for surgery or nonroutine medical tests that are not yet
History completed, or have you been evaluated for an undiagnosed condition?
In the last 3 years, have you received disability payments (excluding pregnancy)?
Have you sustained two or more falls in the last 24 months?
Are you currently using an assistive walking device?
Have you had more than one fracture related to osteoporosis and/or osteopenia?
Are you currently receiving home health services for daily living activities, or are you
currently living in a nursing home?
Have you been issued a disability parking permit for more than 90 days, or have you had
driving privileges limited due to any medical conditions?
Do you have any medical condition that has restricted your mobility or has impacted any of
the six activities of daily living (bathing, continence, dressing, eating, toileting, transferring)?
Do you currently need assistance with any of the six activities of daily living?
Have you been diagnosed with chronic pain and are currently treated with narcotics?
Have you been treated for alcohol or drug use in the past 5 years?
Have you used illicit drugs (other than marijuana) or prescription narcotics in amounts
other than as prescribed in the past 10 years without completing treatment?
Have you received an organ transplant?
Have you been diagnosed or treated for HIV/AIDS?
Heart/Cardio Have you had a heart attack in the last 12 months?
Have you had heart failure or heart enlargement?
Have you had a circulatory disorder resulting from smoking or diabetes?
Have you had heart surgery, including bypass, in the past 24 months (does not include
stent placement)?
Do you currently have an implanted defibrillator, such as a cardioverter-defibrillator?
Immune Have you been treated for an autoimmune disease requiring daily steroid therapy or
more than one biologic agent or immunosuppressant, including rheumatoid arthritis (RA),
psoriatic arthritis, or lupus?
Kidney Have you consulted a doctor or been treated for moderate or severe chronic kidney disease?
Are you on dialysis?
Liver Have you been diagnosed with cirrhosis of the liver?
Are you currently being treated for chronic hepatitis B or hepatitis C?
Lung Have you had chronic obstructive pulmonary disease (COPD), emphysema, or
used oxygen?
Motor Vehicle Have you been convicted of driving under the influence in the last 5 years?
Psych Have you had a mental disorder requiring three or more prescription medications, or have
you had thoughts of suicide?
Decline Medications List
Please note this is not an all-inclusive list. Medications may only
represent the brand name prescription. If you are using a generic,
please verify the brand name.
Acthar Clozapine Gengraf Megace
Adriamycin Clozaril Geodon Mellaril
Aggrenox Cogentin Gerimal Mestinon
Agrylin Cognex Gilenya Metelase
Akineton Comtan Glatopa Methadone
Amiodarone Copaxone Gleevec Methotrexate
Androl-50 Copegus Gold Therapy Mirapex
Antabuse Cortef (hydrocortisone) Haldol Moban
Apidra Cuprimine (D-penicillamine) Hepsera Moditen
Apokyn Cytosar Herceptin MorphaBond (morphine)
Aptivus Cytoxan Humulin MS Contin (morphine)
Aranesp Dantrium Hydergine (ergoloid) Mutamycin (mitomycin)
Arava Decadron Hydralazine Myfortic
Aricept Deltasone (prednisone) Hydrea Myleran
Arimidex Demerol Hysingla ER Namenda (memantine)
Aristada Digox Ifex Navane
Artane Digoxin Iletin Neoral (cyclosporine)
Atgam Dilaudid (hydromorphone) Inamrinone Neupro
Aubagio Dolophine (methadone) Incivek (telaprevir) Nilandron
Aviz Dostinex Infergen Interferon Niloric
Avonex Doxil Intron Nipent
Azilect Duragesic (fentanyl) Invega Nitropress
AZT Duramorph (morphine) Isosorbide Nitrostat
Baraclude Ebixa (memantine) Kadian (morphine) Novantrone
Beatseron Eldepryl Kemadrin Novolog
Betaferon Eligard Kineret Nplate
Bevyxxa Embeda (methadone) Lantus Nucynta
BiCNU Emcyt Larodopa Numorphan
Blenoxane Epogen Latuda Onsolis (fentanyl)
Buprenex Equetro (lithium) Lemtrada Opana
Busulfex (busulfan) Eskalith (lithium) Leukeran Orencia
Butrans Eulexin (flutamide) Leukine Orthoclone
Campral Exalgo (hydromorphone) Levemir Oxandrolone
Carbex Exelon Levo-Dromoran Oxycontin (oxycodone)
Casodex Extavia (interferon) Lioresal (baclofen) Palexia
CeeNU Fanapt Loxitane Parcopa (levadopa)
Cellcept Faslodex Lupron Parlodel
Cerefolin Fazaclo Lysodren Pegasys
Cerubidine Fentora (fentanyl) Matulane Pegatron
Chemotherapy (all forms) Foscavir Medrol Percodan (oxycodone)

Can I skip a payment with OneMain Financial?Can I skip a payment with OneMain financial? If you have a personal loan with OneMain Financial and missed a payment, you can call us at 1-800-961-5577. You might avoid additional late fees and interest charges if you pay it off sooner rather than later.