How to Understand Health Standards for Long Term Care Insurance Enrollment

Copyright (c) 2006 Clay Cotton

Long term care insurance conforms to the basic insurance mechanism, in that the individual risk of future peril is shared by a pool of people who currently are free from that peril.

The insurance pool is represented by the insurance company which sets eligibility standards for enrollment to ensure a hazard-free pool, so that actuaries can calculate reasonable, standardized premiums for pool members who meet the eligibility requirements and enroll in the risk pool. In this way, members transfer their individual risk of peril to the pool. The pool shares the risk for all members and covers those whom actually experience the future peril.

If you are thinking about applying for a long term care insurance policy, please be aware that certain pre-existing health conditions can make it impossible for some folks to enroll due to health reasons. If you have any health issues, this article can help you better understand long term care insurance health requirements.

Do not apply for long term care insurance if you CURRENTLY:

* Use a multi-pronged cane, crutches, oxygen, walker or wheelchair

* Require assistance with bathing, dressing, feeding, toileting, urinary or bowel continence, or transferring between bed or chair

* Use/need home health care, adult day care, assisted living or nursing home care

* Require assistance with grocery shopping, use of transportation, use of telephone or banking

( NOTE: These pre-existing health problems may make you uninsurable for buying a new long term care insurance policy. However, all the above health conditions WILL be covered if they occur AFTER you you have purchased your long term care insurance policy. )

In addition, do not apply for long term care insurance if you CURRENTLY have:

* AIDs or HIV infection
* Alzheimer’s
* Amyotrophic Lateral Sclerosis (ALS)
* Cystic Fibrosis
* Dementia
* Hemophilia (other than Von Willebrand disease)
* Hepatitis C, Non-A, Non-B, or Autoimmune (Active)
* Kidney Failure
* Liver Cirrhosis
* Memory Loss
* Multiple Sclerosis
* Muscular Dystrophy
* Paralysis
* Parkinson’s Disease
* Post-Polio Syndrome
* Schizophrenia
* Sickle Cell Anemia
* Systemic Lupus Erythematosus

Every long term care insurance company has their own health underwriting standards. Each company’s health underwriting standards may vary by state, according to each state’s laws.

Note: As you increase in age, so does your risk for health issues. Therefore, most long term care insurance companies will require medical records for people over 45, medical records and phone interview for people 50 and over, and medical records plus a face-to-face health interview for people over 70.

Be aware: If you think you can slip your health issues past long term care insurance underwriters, then think again. First, lying on your application is fraud. Second, it is the underwriter’s job to be very thorough when looking through your medical records and assessing risk. Be honest with yourself and with the long term care insurance company you choose.

The upshot of all this is that folks must protect themselves while they are still in good health.

If you fall within acceptable guidelines, then “congratulations”, as you can protect your assets and your family’s lifestyle stability now, then cross your fingers and hope that you are not one of the nearly 45% of us who will need care at some point in our lives.