Archive for August, 2017

Are You Healthy Enough To Get Long Term Care Insurance?

August 29, 2017

My job is helping you plan for the day you will need long term care services (assistance with getting through the day).  It is easier to plan when you don’t have major medical issues, but you do not need to be in perfect health to qualify.

Long term care insurance is the planning tool of choice because it is so good at protecting families.  People say that I often get long term care insurance approved for them…in spite of medical history problems.

What exactly does “Healthy Enough” mean?  If you are not healthy enough, can an insurance company turn you down?  Even with or without the existence of Obama Care?  Absolutely!  Obama Care (the Affordable Care Act), unlike for medical insurance, does not impact long term care insurance at all.  Insurance companies can & do decline (turn down) people for long term care insurance when their risk is thought to be too high.


Let’s start with a few examples from a typical long term care insurance company height/weight chart.  The following applies to both women & men: If you are 5′ 0″ tall & weigh between 92-205 lbs…Good!  You are 5′ 6″ tall & weigh between 118-263 lbs…Good!  You are 6′ 0″ tall & weigh between 133-295 lbs…Good again!  At the high end, these are pretty generous allowances compared to those for life insurance.

What source does an insurance company use for determining your height & weight?  Answer: They use whatever is in your medical records from your most recent doctor’s office visit…sometimes further verified by an abbreviated exam.

On the flip side (meaning you cannot get long term care insurance if you have these conditions) a few “knock-outs” are: AIDS, Alzheimer’s disease, arthritis requiring narcotic pain medication, back pain that is disabling or requires narcotic pain medication (see a pattern here?), dementia, organ transplant, Medicaid recipient (receiving heath care through Medicare, the government health insurance for people age 65 & better, is OK), oxygen use, Parkinson’s disease, physical or occupational therapy within the past 3 months, pregnancy, surgery (requiring general anesthesia) that is planned or has been scheduled, use of a walker or wheelchair.

What about a history of cancer?  Answer: It depends.  Breast Cancer: Stages I-III, no metastasis, at least two years since last treatment.  Not a long term care insurance problem.  Basal Cell or Squamous Cell Skin Cancer: Not a long term care insurance problem.  Prostate Cancer: Stages I-III, no metastasis, at least two years since last treatment, and PSA zero or near-zero.  Not a long term care insurance problem.

Any cancers that have metastasized (spread), or recurred: Problem.

Diabetes Type II: Present for less than 20 years, well-controlled & stable with diet & exercise & oral medications, no injected insulin, no diabetic complications, & tobacco free for at least 12 months: Not a long term care insurance problem. Insulin less than 50 units per day, everything else is good: May be able to obtain long term care insurance…everything else really has to be good.

Women taking hormone replacement therapy medications: Not a long term care insurance problem.

Tobacco use within two years: Assuming everything else to be good, you will not have a problem obtaining long term care insurance.  However, you will not qualify for the very best rate class if you are a smoker.

THANK YOU FOR READING TO THE END. None of the above medical conditions apply to your ability to keep long term care insurance after it is effective.  Once you have been through the underwriting process & a policy has been issued & accepted by you, it is yours for as long as you like…provided you pay the premiums when due & have been truthful on the application.

AND MOST IMPORTANT: If you are younger than age 80, fall within the height & weight tables, & have no significant health issues, THEN I CAN FIND: GOOD, AFFORDABLE, LONG TERM CARE INSURANCE, FROM A GOOD COMPANY for you.

ONE OTHER THING: Please do not hurt yourself by assuming that you cannot qualify. Talk to me first.  Insurance is not the only tool I have available for long term care planning.

My intent in writing this article was not to scare you into thinking you had no options. Rather it was to point out that all of us are but one doctor’s visit away from becoming unable to purchase insurance at any price. Each of us will cross that uninsurable threshold at some point in our lives.  Do your planning before it happens.


Disclaimer: Actual policy language, rather than the contents of this eNewsletter always takes precedence.  Long term care insurance policies & underwriting requirements vary widely from company to company & within the same company.  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, 2017