Will I Qualify for Long-Term Care Insurance?
Key Insights
- Long-term care insurance isn’t guaranteed, so you must qualify through underwriting.
- Applying in your 50s or early 60s gives you the best chance of approval and lower premiums.
- Serious health issues or cognitive decline can prevent you from qualifying for coverage.
- The LTCI application process includes medical history, interviews, and prescription reviews.
- If you’re declined, alternatives like hybrid policies, short-term care, or Medicaid may be options.
Spoiler alert: It’s not guaranteed, so timing matters.
When it comes to long-term care insurance (LTCI), most people focus on cost. But there’s another critical question that isn’t being asked enough: “Will I even qualify?”
Unlike health insurance or Medicare, LTCI isn’t guaranteed. You must apply—and you can be denied. The good news? Knowing how insurers assess applicants can help you prepare and improve your chances of getting approved. Let’s walk through how it works.
Why You Need to Qualify for LTCI
Long-term care insurance companies take on a big risk. They may be paying tens or even hundreds of thousands of dollars for your future care, so they want to make sure you’re relatively healthy when you apply.
That means underwriting—reviewing your health, lifestyle, and medical history—before issuing a policy.
The Big Factors Insurers Review for LTCI
- Age: The older you are, the harder (and more expensive) it gets to qualify. Most people apply in their 50s or early 60s, when health is usually more stable.
- Current Health Conditions: Certain conditions are red flags for insurers. You may be declined if you have: Alzheimer’s or other cognitive impairment, Parkinson’s disease, a history of stroke or certain cancers, diabetes with complications, or recent heart conditions or surgeries. (Other conditions may not disqualify you, but they can increase your premiums.)
- Prescription Drug History: Insurers will look at what meds you’re taking to get clues about your health, so be prepared to explain any prescriptions.
- Daily Functioning: If you already need help with bathing, dressing, or mobility, you probably won’t qualify. LTCI needs to be purchased before care is needed.
- Cognitive Screening: Many insurers do a brief memory or cognitive test, especially if you’re over 60. Failing this can lead to denial.
How the LTCI Application Process Works
- Health questionnaire: Includes medical history, surgeries, chronic conditions
- Phone interview or in-person assessment: May include memory test or questions about daily activities
- Doctor records review: Insurers may request info from your primary care provider.
- Prescription check: To see what medications you’ve taken recently
Tips to Improve Your Chances
- Apply early—your 50s are ideal
- Be honest but prepared; don’t try to hide conditions.
- Stay on top of preventive care; insurers love applicants who manage their health well.
- Work with a specialist who can match you with a carrier that fits your health profile.
What If You Don’t Qualify for LTCI?
You still have options:
- Hybrid policies (life insurance with LTC riders) often have more lenient underwriting.
- Short-term care insurance may be easier to get and provide limited coverage.
- Annuities with LTC features can help self-insure with some built-in support.
- Medicaid is a safety net for those with limited assets, but it comes with strict rules.
Bottom Line: The Sooner, the Better
Waiting until you’re “closer to needing care” is the #1 mistake people make with LTCI. The longer you wait, the higher the chance your health or age will disqualify you. If long-term care insurance is something you’re considering, don’t wait until you need it.
Start the conversation while it’s still your choice to make.
