Financial & Health Qualifications

There are two reasons people cannot qualify for long term care insurance

  1. They do not have income or assets to justify the insurance.
  2. They cannot health qualify.

FINANCIAL QUALIFICATIONS

You probably should not purchase long term care insurance:

  • if you currently receive or may soon receive Medicaid benefits
  • if you have limited assets and can't afford the premiums over the lifetime of your policy
  • if your only source of income is a social security benefit or supplemental security income.


HEALTH QUALIFICATIONS

Not everyone can health qualify for long term care insurance. Don't assume you can and don't assume you can't, find out.

40% of those receving long term care are under 65.

The older you get the more likely you may not health qualify for long term care insurance. If you cannot health-qualify then you need to make other plans such as a fixed annuity with a long term care rider.

The guidelines listed below are provided to help you determine if you might health qualify:

  • A person should be able to perform activities of daily living such as bathing, dressing, eating and walking.
  • A person should have the ability to handle daily activities such as finances, housework, laundry and meal preparation, shopping, taking medications and transportation.
  • A person should have the ability to function without assistance from another individual or mechanical device (e.g. a walker, wheelchair, oxygen or dialysis.)
  • A person should have clarity of thought with no signs of memory loss, confusion or forgetfulness.
  • All acceptable medical conditions must be stable and well controlled. (Medical conditions should not be severe or deteriorating, e.g. anticipating surgery, medical work-up in progress or undergoing physical therapy.)

If you respond yes to any of the following you may not be eligible to apply for long term care insurance and may need to make other plans such as a fixed annuity.

Have you had, do you currently have or have you ever been medically diagnosed as having any of the following:

  • AIDS
  • ALS (Lou Gehrig's Disease)
  • Alzheimer's Disease
  • Cirrhosis of the liver
  • Dementia
  • Diabetes under treatment with insulin
  • Diabetes Type II and heart problems
  • Frequent or persistent forgetfulness
  • HIV
  • Memory loss
  • Metastatic cancer (spread from original site/location)
  • Multiple sclerosis (MS)
  • Muscular dystrophy
  • Organic brain syndrome
  • Parkinson's disease
  • Senility
  • Stroke
  • Transient Ischemic Attach (TIA) within the past 5 years
  • TIA in combination with diabetes or heart surgery
  • TIA two or more times
  • Do you use a walker or wheelchair; oxygen; respirator; or kidney dialysis; or need assistance or supervision by another person performing any of the following: moving in/out of bed or chair; bathing; eating; toileting; bowel/bladder control; walking?
  • In the past 6 months have you had: open heart surgery; back or spine surgery?

This is a partial list. Contact us if you have any questions.

If you do not have any of the above conditions but do have health issues the only way to find out if you can get LTC insurance is to apply for it. There is no obligation to see if you qualify.

Unless you haven't seen a doctor in over 2 years normally only a medical records review is required. If it has been more than 2 years you should at least have a checkup before applying.

Depending on the benefits you want, your health and age, a phone or in-person health interview with a nurse may be requested. We will tell you what is involved in your interview when you apply for insurance through us.

In addition to the list above LTC underwriters will look at the overall health of a person and there may be a combination of health issues that prevent underwriting.

It's no surprise that a number of applicants are turned down because of health issues and today more and more people are declined because of weight. If you have hypertension, high-blood pressure, type II diabetes, or pre-diabetic you should see if you qualify before your health changes and you become uninsurable.

The risk that our health may change is real and it is not something we can plan for, but planning for long term care is something we can do.

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