If you have purchased health insurance, you likely understand that you are guaranteed coverage.  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.