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:

Cirrhosis of the Liver
Cystic Fibrosis
Dementia or Loss of Memory
Multiple Sclerosis
Muscular Dystrophy
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.