Absolutely yes, you can get coverage for long-term care if you have pre-existing conditions. It is a misconception that you can’t get coverage if you are not 100% healthy. While not having any conditions might get you a better rate, it is not impossible to get an affordable rate while taking some medications or being treated for some illnesses.
Every carrier looks at health information different, which means that you might have to shop around to find a company that will accept you.
What conditions can you get long-term care insurance with?
First let’s discuss what conditions you can have and still get accepted for a long-term care insurance policy. There are many common conditions, such as high blood pressure and high cholesterol, that insurance companies do not mind as long as it’s under control and it has been stable for a while. Some conditions, such as diabetes, can be okay with some insurance companies, depending on how much insulin you use or if you’ve had any complications caused by the diabetes. Even conditions like heart attacks, joint replacements, and kidney failure can be okay if they occured over a certain number of years ago.
It is important to note, that while the above conditions do have a chance to be accepted by some insurance companies, if you have them in combination with other conditions, you likelihood of getting accepted decreases. The most common denied combinations are conditions paired with height to weight ratios and tobacco usage.
It is important not to lie on your application. If a company finds out that you were not truthful, they might not pay for treatment related to the condition lied about. They can even cancel your policy. The normal look back period to find these mistakes is 2 years, but if the company can show that you intentionally mislead them, this period can last longer than 2 years.
While health insurance companies ask about a lot of different conditions, if you buy your long-term care insurance before you develop one of the health conditions listed, then your policy will cover the care you need for that condition.
What conditions can you not get long-term care insurance with?
The easiest rejection for insurance companies to give out is if you currently need help with any of the 6 Activities of Daily Living, which are eating, bathing, dressing, toileting, transferring, and continence. You can see even in the simplified underwriting, they ask this questions. This is because, to qualify as needing long-term care services, you must not be able to perform 2 out of these 6 activities. If you already cannot perform one, that does not look good to the insurance companies. If you are already in a nursing home, you will absolutely not be accepted.
A few other reasons you will get denied: if you use a walker, you have Alzheimer’s, you have certain cancers, you have AIDS, you have had a recent stroke, or you have Parkinson’s disease.
Like we mentioned in the previous section, combinations of certain illnesses, as well as illnesses paired with certain height to weight ratios or with tobacco, will get denied easier. These combos indicate to insurance companies that you have an increased risk of being chronically ill.
Who is actually denied long-term care coverage?
While we can discuss the specifics of what health conditions will get you denied, it can be enlightening to look at the numbers. It
makes sense that as you age, insurance companies are more likely to deny you, because it is more likley that you have developed more health conditions. As you can see from the chart, even at 79 years old, there is less than a 50% chance that you will get denied. It is important to consider that many of these denials can come from not properly looking into each company’s policies. While one company might deny you, you could get approved by another.
| Age of Applicant | Average Declined Percentage |
| Under 50 | 7.3% |
| 50-59 | 13.9% |
| 60-69 | 22.9% |
| 70-79 | 44.8% |
| 80 and over | 69.8% |
Types of Long-Term Care Insurance
There are 3 different types of long-term care insurance: Traditional Long-Term Care, Hybrid Long-Term Care, and Short Term Care.
Each of these provides different benefits and has varying levels of difficulty in health questions.
Traditional definitely has the most stringent health questions, as it usually is offering the greatest benefit, monetary wise. Hybrid varies from simplified underwriting to more difficult, full underwriting. It really depends on which companies policy you are going with. Short term care insurance has the easiest underwriting as it is covering only a year of care. Short term care insurance companies will also accept you even if you have been rejected by long-term care insurance policies. Even if you do not have options with one type of insurance due to health conditions, you might have options with a different type.
If your health disqualifies you from getting any insurance, your best, and really only, route is self-insurance. Self-insurance requires that you have a plan for how you are going to pay the long-term care bill. Having a plan will ease the burden on your family and friends if the time comes. This option can also be mixed and matched with insurance options to find the best solution for your own personal situation.
With how difficult it can be to find the right company and policy for you and your health conditions, it is easy to see why it is important to to work with a professional that understands the guidelines and health qualifications of multiple companies. An experienced insurance agent should gather your health history and current health status before recommending which companies are most likely to approve you. Make sure to work with an agent who works with multiple insurance companies, not just one, so they can truly recommend the best product for you.
