Long Term Care Insurance Eligibility And Premiums

Long-term care insurance companies go through a process to determine whether or not you’re eligible for an insurance plan, and how much you’ll pay in premiums based on your personal health and projected future needs. Almost all insurance companies use this process, called “underwriting,” to evaluate the needs of potential clients and determine eligibility and premiums.

Step #1: The Application

After submitting an initial form requesting information about long-term health care, you’ll need to fill out a more detailed application. This officially initiates the underwriting process, which may include phone interviews, in-person interviews and medical evaluations. Be both forthright and thorough during this initial step to ensure that you get the long-term health care that best fits your needs.

Step #2: The Interview

Some insurance companies will schedule a phone consultation with the long-term care insurance applicant, while other companies prefer to handle these interviews in person. During this casual interview, the insurance agent will ask questions about your day-to-day life, living habits, hobbies, medications and lifestyle.

The purpose of this interview is to identify any elements of your lifestyle, health or background that may make you an insurance risk, as well as to ensure that you’re in good health and good cognitive function. Make sure to answer all the insurance agent’s questions honestly.

Step #3: The Medical Exam

You’ll likely have to undergo a medical in the initial stages of the underwriting process, whether it be with your own family doctor, or with a doctor or nurse hired by the long-term care insurance company. The doctor will examine your general physical condition, vital signs and heart rate, and work up a basic medical profile for the insurance company, which will greatly affect your eligibility and premiums.

Step #4: The Medical Record Review

The insurance company will also request access to your medical records, allowing them to evaluate any conditions that you’ve had in the past, as well as any that you’re currently being treated for.

The entire underwriting process helps to determine the benefits for which you’re eligible, as well as your long-term care insurance premiums. A good insurance company will work with you every step of the way, getting the information that they need as quickly and conveniently as possible—after all, they’re hoping to have you as a paying client. Keep this in mind as you go through the process and negotiate the terms of your policy.


DIBroker (n.d.) Underwriting.Retrieved October 29, 2010, from http://www.dibroker.com/underwriting/

Lipham, D. (2010). Long-term care insurance: The application and underwriting process. Retrieved October 29, 2010 from http://www.caring.com/articles/long-term-care-insurance-underwriting-application