Regardless of how much you are willing to pay for long term care insurance, no company will sell it to you unless you qualify medically. The following is a sampling of uninsurable health conditions taken from one carrier’s actual underwriting guide:
Using Adult Day Care within the past 6 months, AIDS, a history of alcoholism with any current alcohol use, ALS (Lou Gehrig’s Disease), Alzheimer’s, in an Assisted Living Facility within the past 6 months, Chron’s Disease with complications or multiple flares, COPD (Chronic Obstructive Pulmonary Disease) combined with tobacco use within 12 months, dementia, diabetes (if poorly controlled, or with tobacco use, or if injecting more than 50 units of insulin per day),
Dialysis, disabled (If collecting private disability insurance or Social Security disability benefits. Collecting Social Security retirements benefits is OK.), Down’s Syndrome, electric scooter use, epilepsy (if poorly controlled), hemophilia, high blood pressure if more than 170/94 or if noncompliant with treatment, HIV positive, using Home Health Care within the past 6 months, immune deficiency, mental retardation, multiple myeloma, multiple sclerosis,
Muscular dystrophy, in a Nursing Home within the past 6 months, organ transplant, osteoporosis with a T score of -4.0 or worse, oxygen use, Parkinson’s, physical therapy within 3 months, polycystic kidney disease, pulmonary hypertension, quad cane use, rheumatoid arthritis (severe), schizophrenia, shingles (within 6 months), surgery requiring general anesthesia either scheduled or planned (but not yet completed), systemic lupus, walker use, workers’ compensation (currently receiving). There are many, many more disqualifying conditions (as well as combinations of conditions). I only listed some.
Build: The height and weight tables vary slightly from insurance company to insurance company. Most now use a single chart for both men and women. Pay attention to the minimum as well as maximum allowable weights for a given height. Here are a few examples from another insurance company.
5’0″ and 92-203 lbs is OK. 5’4″ and 105-231 lbs is OK. 5’6″ and 112-246 lbs is OK. 5’10” and 126-277 lbs is OK. 6’0″ and 133-293 lbs is OK. Other companies may be a little more or less stringent.
What about cancer? Internal cancer is often insurable if there has been no lymph node involvement or metastasis, and a low stage/grade number, and at least two years since last treatment.
The take-away from all this doom and gloom? If you have the good fortune of not having been diagnosed with a disqualifying medical or psychological condition, you should apply for long term care insurance while you still can. If you already have a policy, keep it! You cannot be cancelled because of a change in health.
Think about it: we are all potentially one doctor visit away from a diagnoses that will make us uninsurable. The reality of life is that we will all become uninsurable at some point. The only question is: When?
Disclaimer: This eNewsletter and all links to other sources should not be construed as tax or legal advice because they are neither. Raymond Smith, The Long Term Care Specialist, does not give legal or tax advice. Consult your attorney or tax advisor for these matters.
© Raymond Smith, The Long Term Care Specialist, 2014
Planning for Long Term Care 