6 Potential Roadblocks to Getting Long-Term Care Insurance: As we navigate the challenges of building a career, raising children, and managing a household, it can be difficult to envision a future where we might need help with basic daily tasks. Yet, the reality is that aging comes with its own set of care requirements. According to recent statistics, nearly 70% of people turning 65 today will need some form of long-term care in their lifetime. This makes long-term care insurance not just a smart investment—but an essential one.
“Don’t assume you’ll never need long-term care,” warns Holly Snyder, President of Nationwide’s life insurance division. Nationwide’s survey found that almost a third of retirees regret not planning for their future care needs sooner. With the rising cost of care services, having long-term care insurance coverage can prevent financial strain and protect your family from emotional and economic burden. This insurance ensures you have access to high-quality care whether at home, in assisted living, or in skilled nursing facilities.
However, obtaining long-term care insurance isn’t as straightforward as purchasing life or auto insurance. Many applicants face rejections due to age, pre-existing health conditions, or misunderstanding the application process. It’s critical to understand the eligibility requirements, how much it costs, how to apply, and how to make the most out of your policy before you need it. In this article, we’ll guide you through everything you need to know about long-term care insurance—including the six biggest roadblocks, who can apply, coverage costs, and practical tips to improve your chances of approval.
Six Potential Roadblocks to Getting Long-Term Care Insurance
1. Pre-existing Medical Conditions
Health plays a major role in insurance approval. Conditions like Alzheimer’s disease, Parkinson’s, multiple sclerosis, or recent history of cancer may lead to automatic disqualification. Even if you’re managing your condition well, insurers might view you as high-risk.
2. Advanced Age
Most providers have a cutoff age for new applicants—usually around 75 years old. The younger and healthier you are when you apply, the more likely you are to be approved and offered lower premium rates.
3. Cognitive Impairment
Applicants must go through cognitive screening. If you show signs of dementia or impaired memory during the evaluation, insurers may deny coverage even if you’re otherwise physically healthy.
4. Obesity and Lifestyle Choices
Obesity, smoking, excessive alcohol use, and lack of physical activity are seen as indicators of future health complications. These lifestyle factors may result in higher premiums or disqualification.
5. Lack of Financial Stability
Long-term care policies are expensive. Insurers often assess your financial readiness to pay ongoing premiums. If you’re deemed unable to afford the plan long-term, you may be rejected.
6. Incomplete or Inaccurate Applications
Failing to disclose your full medical history or submitting incomplete information can result in an automatic denial. Always ensure accuracy and honesty in your application.
Who Can Apply for Long-Term Care Insurance?
Most insurers target applicants between ages 50 and 65, but younger applicants can apply too. You must:
- Be in relatively good health
- Have a clean cognitive assessment
- Provide full disclosure of medical history
- Show financial capability to pay premiums
Some employers offer group long-term care insurance policies with less strict underwriting, so it’s worth checking if your workplace has a group plan.
Insurance Fees: How Much Does It Cost?
Long-term care insurance premiums depend on multiple factors:
| Factor | Impact on Cost |
|---|---|
| Age | The older you are, the higher the premium |
| Gender | Women pay more due to longer lifespans |
| Health status | Pre-existing conditions raise costs or cause rejection |
| Benefit amount | Higher daily/monthly benefit limits increase premiums |
| Benefit period | Longer coverage periods cost more |
| Elimination period | A shorter wait time before benefits start costs more |
Average annual premiums for a 55-year-old couple:
- $2,500 to $3,500 for shared benefits
- $1,500 to $2,500 for individual plans
How to Use and Benefit from Long-Term Care Insurance
Once approved and active, your policy can cover:
- In-home care (bathing, dressing, meal prep)
- Assisted living facility costs
- Skilled nursing facility care
- Adult daycare services
- Hospice or respite care
Benefit Triggers
You become eligible for benefits when you can’t perform at least two of six Activities of Daily Living (ADLs) such as eating, dressing, toileting, bathing, transferring, or continence—or if you suffer from cognitive impairment. Nationwide Long-Term Care Insurance Info
Claim Process
- File a claim with documentation from a licensed health provider.
- Undergo a care assessment.
- After meeting the elimination period (usually 30–90 days), benefits begin.
How to Apply for Long-Term Care Insurance
Step-by-Step Application Process
- Research Providers
Choose reputable insurers such as Nationwide, Genworth, Mutual of Omaha, or New York Life. - Get a Quote
Submit personal details to receive customized pricing. - Complete a Health Interview
This can be done over the phone, online, or in person. - Undergo Medical Exams
Includes cognitive assessments, sometimes blood or urine tests. - Wait for Approval
The underwriting process may take 2–6 weeks. - Sign the Policy & Pay Premiums
Once approved, pay the first premium to activate your policy.
Important Dates to Remember
| Milestone | Details |
|---|---|
| Ideal Age to Apply | Between 50–65 years |
| National Long-Term Care Awareness Month | November |
| Annual Premium Review | Once every 12 months |
| Claim Evaluation Period | After 30–90 day elimination period |
Disclaimer
This article is for informational purposes only and should not be considered financial or legal advice. Policy features and underwriting guidelines may vary by insurer and state. Always consult with a licensed insurance agent or financial advisor before making any decisions regarding long-term care insurance.
6 Potential Roadblocks to Getting Long-Term Care Insurance Conclusion
Planning for long-term care may not be at the top of your mind, but doing so early can save you from immense financial and emotional distress later in life. A proactive approach ensures your future care needs are met without compromising your lifestyle or family legacy.
While roadblocks like age, health conditions, and financial instability can make obtaining coverage difficult, being informed and prepared significantly increases your chances of approval. Start by assessing your current health, budgeting for the cost, and exploring different policy options available to you.
Long-term care insurance offers peace of mind, empowering you with choices about how and where you want to receive care. It’s not just a safety net for you—it’s a gift of freedom and security for your loved ones.
Don’t wait until you need care to start thinking about how to pay for it. Explore your options, consult with experts, and take control of your future—starting today.
6 Potential Roadblocks to Getting Long-Term Care Insurance FAQs
1. What age is best to apply for long-term care insurance?
The best time to apply is between ages 50 and 65, when premiums are more affordable, and you’re more likely to be approved. Waiting until your 70s may result in higher costs or disqualification due to health issues.
2. What does long-term care insurance typically cover?
It covers services that assist with daily living activities such as bathing, dressing, eating, and mobility. This includes care provided at home, adult daycare centers, assisted living, and nursing homes.
3. Can I get long-term care insurance if I have a pre-existing condition?
It depends on the condition and its severity. Some insurers may accept applicants with manageable health issues, while others may deny coverage outright. Always disclose full medical history for accurate evaluation.
4. Is long-term care insurance tax deductible?
Yes, premiums can be tax-deductible depending on your age and tax filing status. Consult a tax advisor for specific eligibility and deduction limits based on IRS guidelines.
5. What happens if I can’t afford the premiums later?
If you stop paying premiums, your policy may lapse, and you could lose your coverage. Some policies offer non-forfeiture benefits or paid-up options, allowing you to retain partial coverage. Always review these options before purchasing.
