Category Archives: Underwriting

Do You Qualify for Long Term Care Insurance?

Long Term Care Insurance (LTCI) underwriting differs from most other insurances you buy. Auto and Homeowners insurance rarely ask personal questions about your health while Life insurance gets more personal with physicals and urine, blood, and saliva tests.

Many people think since they passed Life insurance underwriting they’ll qualify for Long Term Care Insurance. Unfortunately, that’s not always the case. With Life insurance, insurance carriers are underwriting for your mortality. With Long Term Care insurance, they underwrite for your morbidity.

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Long Term Care Insurance Interview Questions: Know What to Expect

When you apply for Long Term Care insurance, many carriers require applicants to complete a personal health interview as part of the underwriting process.

For many individuals, not knowing what to expect in an interview can make people nervous. The more you know about the interview and process, the more comfortable and prepared you’ll be when it’s time for your personal health interview.

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What to Expect in Long Term Care Insurance Underwriting

You sent in your long term care insurance application – what’s next?

To get approved for coverage, applicants are required to go through long term care insurance underwriting. This process can generally take 6-8 weeks for the carrier to obtain your medical information, conduct interviews, and make a decision.

Here are some scenarios of what to expect in long term care insurance underwriting that may take place when you apply for long term care insurance.

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Long Term Care Insurance with Pre-Existing Conditions

Are pre-existing conditions keeping you from getting coverage? Long term care insurance coverage isn’t only bought with your money. It’s bought with your health too.

Unlike medical insurance which doesn’t pre-screen your health before offering coverage, long term care insurance requires medical underwriting. Long term care underwriters use medical records, phone health interviews, and face to face interviews to determine if you’re eligible for coverage.

Certain conditions in your health history may make you ineligible for long term care coverage.

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Qualifying for Long Term Care Insurance With Pre-Existing Conditions

If you have purchased health insurance, you likely understand that you are guaranteed coverage.  The new health care reform law allows you to buy health insurance regardless of having a pre-existing medical condition.  Long term care insurance (LTCI) does not fall under that rule.  LTCI carriers assess the risk that an applicant will likely live with a condition that may impact their ability to function independently later.  If you have a pre-existing condition, a LTCI carrier will take that into consideration when making a decision.

There are certain conditions you may be declined coverage for with long term care insurance.  Some of these reasons are if you are currently needing help with any of the 6 activities of daily living (ADL), use a walker, have Alzheimer’s, certain forms of cancers, or Parkinson’s Disease, among other things.

There are also more common illnesses that, if occurring in combination with others, would make a person ineligible for coverage.  For example, an applicant with diabetes in combination with an increased height to weight ratio, or tobacco use, not only has two diseases to manage, but these combined increase the risk of being chronically ill.  An applicant’s height to weight ratio or their use of tobacco almost always has a direct effect on other medical conditions increasing the possibility of becoming “chronically ill,” and therefore would be declined.

You may be thinking, “There is no chance I can get coverage!”  Don’t count yourself out just yet.  Every carrier looks at health information a bit different, just because one may not grant you coverage, another may consider you.  The key is to apply with your best bet first, as a large portion of insurance companies will not consider you if another company has already declined your request for coverage.  That is why we recommend speaking to our consumer specialists about your specific needs, health, and situation.  Request information today and see if you qualify for long term care insurance.

LTC Consumer is an independent, free online service to help consumers understand what long term care insurance is, how it works, and how to evaluate coverage options. Our mission is to provide an educational, no-pressure resource for learning about long term care planning, with the opportunity to speak with specialists who can help them.

Why is it best to buy Long Term Care Insurance at a young age?

Many people are not aware that you must health qualify to obtain a long term care insurance policy.* Long term care insurance companies do not fall under the Affordable Care Act, therefore are allowed to base their decision on a pre-existing medical condition.  As you can imagine, this can be frustrating for consumers.

To help avoid this frustration, we recommend planning for long term care early, ideally in your mid-50’s, but any time between 50-60 years of age.  Long term care insurance carriers care what shows up in your medical records.  As you age you are more likely to have additional trips to the doctor, prescriptions and/or diagnoses, all which can affect your ability to get approved for a policy.  By applying early, you have a better chance of health qualifying for coverage.

Not only do you have a better chance of even qualifying, but most carriers offer a discount for preferred health.  Once you are approved for the discount and accept your policy, the discount stays with your policy and doesn’t change just because your health does.  As you age and your health declines, so does your chance of qualifying for this preferred health discount.

Another reason to apply at a young age would be to save money!  Many factors affect the price of long term care insurance, but one of the driving factors is age.  The younger you are, the less you pay.  The cost of a single man age 60 for an average policy is roughly $180 per month.  That same policy only 5 years later increases 31% to $240 per month.  We see our average buyer is 56, so start planning today!

If you’re ready to find out more about the cost of long term care insurance, or if you may be eligible, speak to one of our specialists today, or check out the cost for yourself.  You have nothing to lose and everything to gain.

LTC Consumer is an independent, free online service to help consumers understand what long term care insurance is, how it works, and how to evaluate coverage options. Our mission is to provide an educational, no-pressure resource for learning about long term care planning, with the opportunity to speak with specialists who can help them.

* See our blog post titled Long Term Care Underwriting and What to Expect During the Application Process for more details on qualifying.

Long Term Care Insurance Underwriting and What to Expect During the Application Process

We tell consumers that while they pay for long term care insurance (LTCI) with their dollars they BUY the coverage with the health.  For those that want to buy LTCI they must first pass medical underwriting.  Insurance carriers will review each applicant’s prescription drug usage, medical records and for many require a blood and urine analysis and test for cognitive issues.  Do not worry, the majority of people under age 60 are approved but it is important to buy the coverage before a chronic condition becomes diagnosed.

Long term care insurance underwriting standards vary by provider, state, and year, but some factors tend toward the universal.

Gender – women generally live longer and are more likely than men to require long term care.

Family health history – if it is judged that you may inherit a certain disease, you may not qualify.

Age – under 60 you have a better than 50-50 chance of qualifying; over 60, less.

And most impactful of all, personal health history and current medical status – this can be a deal-breaker, if you already need long term care, or have a serious medical condition such as the following:

AIDS/HIV
ALS
Alzheimer’s
Arthritis
Cirrhosis of the Liver
Cystic Fibrosis
Diabetes
Dementia or Loss of Memory
Hepatitis
Hutchinson’s
Lupus
Multiple Sclerosis
Muscular Dystrophy
Osteoporosis
Parkinson’s
Renal Disease
Sickle Cell Anemia

Please note that this is not a complete list, but only a suggestion of some of the prevalent types of pre-existing conditions that many insurers cite as disqualifying an applicant from receiving long term care insurance.

Finally, the industry is evolving. The number of claims has increased in the last few years, prompting insurers to look more closely at underwriting standards, and to tighten them up. Some providers
may require urine tests, blood tests, genetic tests, or other examinations before granting coverage. Insurance is insurance, and business is business. As a consumer, learning more about your options sooner rather than later is a smart item to put on your to-do list.

LTC Consumer is an independent, free online service to help consumers understand what long term care insurance is, how it works, and how to evaluate coverage options. Our mission is to provide an educational, no-pressure resource for learning about long term care planning, with the opportunity to speak with specialists who can
help them.

How your parents health can affect YOUR Long Term Care Insurance

Genes matter. They make your eyes blue, your skin brown, or your heart strong. They can also make you less prone to inheritable diseases that insurance actuaries pay attention to. If your parents and grandparents did not have certain ailments that would have made their need for long term care more likely, your chances of qualifying for long term care insurance could go up a little. And your premiums could go down.

Then there are diseases that leave you relatively healthy medically but impose assistance in daily living. These include coronary artery disease, Alzheimer’s, dementia, stroke, multiple sclerosis, and – especially notorious in terms of qualifying for LTCI – Huntington’s disease. In fact, it’s 50-50 that someone whose parent had Huntington’s will have it too, and unfortunately that’s a risk LTCI providers are not willing to take.
(No one ever said life was fair.)

And what about ObamaCare? The Affordable Care Act does not let insurance adjusters set rates for traditional healthcare insurance based on pre-existing conditions.  Unfortunately, this part of the law DOES NOT apply to long term care insurance. For better or for worse, genes matter.

There’s a flip side, too. The better your family health history is, and the more healthy you are, could mean you are more likely you are to end up needing long term care eventually, because you’re more likely to live a very long life. Catch 22! So your best course is to do a little homework about your parents’ and grandparents’ major health issues, and then consult with an expert about the effects on potential premiums for long term care insurance coverage for yourself. If the forecast is somewhere between terrible and terrific,
LTCI may be right for you.