YOU NEED TO UNDERSTAND CERTAIN MEDICAL CONDITIONS ARE COMMON REASONS FOR POSTPONEMENT.
Each company has its own set of guidelines that can result in a postponement for underwriting consideration.
Here are a few reasons requiring a 6-month wait after the following events. They are heart angioplasty or bypass surgery, carotid artery surgery, heart attack, heart valve replacement, stroke, TIA and joint replacements. Scheduled surgery in the next two to three months, or some serious medical conditions that are situational with a full recovery expected in a couple of months. You will also have to be released from doctor’s care, no use of medical devices and back to a normal activity level.
Postponement does not mean DECLINE!
Certain pre-existing medical conditions, medications, having signs of needing long-term care or the beginning symptoms of cognitive impairment such as orientation, attention, memory, judgment, and comprehension will result in an immediate decline for any type of an insured long-term care solution.
This is a partial list of reasons for an automatic decline:
AIDs or HIV infection / Alzheimer’s Disease / (ALS) Lou Gehrig’s Disease / Certain Types of Cancer (Internal not cured or in remission) / Chronic Bronchitis and have used tobacco in the past year / (COPD) Chronic Obstructive Pulmonary Disease and have used tobacco in the past year / Cognitive Impairment / Congestive Heart Failure / Cystic Fibrosis / Dementia / Emphysema and have used tobacco in the past year / Hemophilia / Active Hepatitis C, Non-A, Non-B, or Autoimmune Disorders / Huntington’s Chorea / Hydrocephalus / Kidney Failure or receiving dialysis / Liver Cirrhosis / Memory Loss / Mental Retardation / (MS) Multiple Sclerosis / Muscular Dystrophy / Multiple Myeloma / Myasthenia Gravis / Previous Organ Transplants, Excluding Kidneys / Paralysis / Parkinson’s Disease / Psychosis / Post-Polio Syndrome / Schizophrenia / Sickle Cell Anemia / Systemic Lupus Erythematosus / Scleroderma, Schizophrenia / (TIA) Transient Ischemic Attack or mini-stroke in the past 2 years / Stroke single episode in the past 2 years / Two or more strokes or TIA’s
Certain medications treating serious medical illnesses will also result in a decline.
Other issues that will cause an automatic decline:
Have you previously been declined for LTC?
Are you disabled? Do you use a disability placard? Are you receiving any disability benefits including personal, state, workers’ compensation, social security?
Do you use a quad cane, crutches, walker, electric scooter, wheelchair, oxygen, respirator or dialysis?
Are you non-compliant with medications and / or treatment?
Are you under or over certain height / weight guidelines?
Have you not pursued additional medical testing recommended by your physician?
Do you have a medical conditional listed as a “decline” in the companies underwriting guidelines?
Have you been confined to a nursing home or assisted living facility in the last six months?
Have you received home health care services or adult daycare in the last six months?
Are you requiring assistance with ADL (activities of daily living – bathing, dressing, feeding, toileting, urinary or bowel continence, or transferring between your bed or a chair)?
Do you require assistance with grocery shopping, transportation, banking or the use of telephone?
Have you received occupational, physical or speech therapy in the last three months?
THESE RISK FACTORS AND GENERAL GUIDELINES ARE NOT MEANT TO BE ALL INCLUSIVE. Due to the complexity of individual case medical histories, multiple co-morbid medical conditions could still result in a postponed decision or decline even if not listed here. The underwriter will decide based on the application and disclosed information provided in the telephone or face-to-face interview.
The approach I always want to take is to determine everything
in advance so there are no underwriting surprises.
I have stated on my website. Your insurability, which allows you to qualify for insurance, can also change at a moments notice. One may not realize the importance of insurability until it changes. This is why proper insurance planning ALWAYS has to occur in advance of a serious medical diagnosis or the need for actual care. When it comes to long-term care insurance, there’s an old saying; “your health buys long-term care insurance, money only pays for it.”
