what disqualifies from long-term care insurance

Thinking about long-term care insurance is a smart way to plan for your future, giving you peace of mind about potential needs down the road. But it’s important to know that not everyone who applies will be approved. Insurers carefully evaluate your health and medical history to assess their risk, which means certain conditions can make it difficult to get coverage. Understanding what disqualifies from long-term care insurance is a crucial first step in the planning process.

Navigating the Health Underwriting Process

When you apply for a policy, you’ll go through a process called underwriting. The insurance company will review your application, often asking for access to your medical records and sometimes requiring a phone interview or a paramedical exam. They are looking for any signs of existing conditions that are likely to require care in the near future. Being prepared for this scrutiny can help you set realistic expectations.

What Disqualifies from Long-Term Care Insurance: Common Health Conditions

While each insurer has its own guidelines, some health issues commonly lead to denial. These typically include conditions that require significant assistance with daily activities right now or are very likely to in the near future. Major red flags for insurers often involve cognitive decline, mobility issues, and chronic illnesses that are currently being managed but have a high probability of progression.

Specific Conditions That Raise Concerns

If you currently need help with activities like bathing, dressing, or eating, you will likely not qualify. From a medical standpoint, a diagnosis of Alzheimer’s disease or any other form of dementia is almost always an automatic disqualifier. The same is often true for certain progressive neurological diseases like Parkinson’s or MS, especially if you’re already showing significant symptoms. Other conditions that can lead to denial include a recent stroke, metastatic cancer, or oxygen therapy for COPD.

Planning Ahead for Your Application

The key to securing long-term care insurance is to apply when you’re still relatively healthy. Don’t wait until you have a diagnosed condition or start needing minor help around the house. If you are denied coverage, it’s worth asking the insurer for the specific reason and shopping around with other companies, as their standards can vary. For some, alternative products like hybrid life insurance policies with long-term care riders might be an option worth discussing with a financial advisor.

While the underwriting process can seem daunting, being aware of these common disqualifiers empowers you to make informed decisions. The best time to secure a policy is before significant health issues arise, ensuring you have a plan in place to protect your future well-being and assets.