One of the most common reasons people avoid exploring long-term care insurance (LTCI) coverage is a simple belief: “I have too many health issues, so I won’t qualify anyway.”
This assumption stops the conversation before it even begins. The reality? Underwriting is far more nuanced than most people think. Having health conditions does not automatically disqualify you. In fact, many individuals with medical histories are still approved, especially when those conditions are stable, well-managed, and properly documented.Insurance carriers look beyond just a diagnosis. They evaluate the full picture, including:
| Carolyn Vader Insurance Underwriting and New Business Manager Krause Agency |
For example, conditions like controlled diabetes, high blood pressure, or even certain past medical events may still be insurable depending on the circumstances.
Another key factor is not all carriers assess risk the same way. What results in a decline with one insurance company could be an approval or even a modified offer with another. This is why pre-qualification and proper carrier selection are critical.
There are also multiple solution paths available:
Each comes with its own underwriting approach, creating more opportunities than many people realize.
An 80-year-old female initially appeared to be a higher-risk applicant due to indicators like a handicap placard and gabapentin use. Her traditional LTCI application was declined based on prescription and MIB reports, along with a prior recent decline. Instead of stopping there, the case was repositioned to a hybrid solution.
The Outcome: Approved at a Preferred rating with a Long-Term Care rider – far better than expected
A 65-year-old female assumed she wouldn’t qualify for LTCI due to a history of Bipolar II. However, she had no hospitalizations, had been stable for years, and maintained a highly active lifestyle including running a farm and training dogs. Her medications were consistent and well-managed:
Despite a prior decline, the case was re-evaluated with a different carrier.
The Outcome: Class 1 approval was still achievable with proper positioning.
A 66-year-old client with a recent Parkinson’s diagnosis remained very active with minimal symptoms and no functional limitations.
The Outcome: Not eligible for traditional LTCI, but approved for a short-term care solution, ensuring meaningful protection was still in place
Some diagnoses may automatically decline for traditional LTCI, but that doesn’t mean the conversation ends. Knowing when and how to pivot to short-term care or hybrid solutions is critical. The key is to lead with solutions, not limitations.
Too many people assume the answer is “no” and never explore their options. But even if coverage looks different than expected, having some plan in place is almost always better than having none.
The better approach? Start the conversation.