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National Advisory Center for Long Term Care Insurance

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Common Guidelines for Long Term Care Insurance Eligibility

Are You Insurable?


If you are currently in general good health, then you may qualify for long term care insurance coverage. But if you are over insurers' age limits for obtaining coverage or have certain pre-existing health conditions, it may be difficult to obtain long term care insurance.

Note that once you obtain coverage, you may not be excluded from benefits due to health. These guidelines apply only to your health on or before the date your policy is issued.

Although underwriting guidelines may vary by insurer, below are some pre-existing conditions that may prevent you from obtaining long term care insurance coverage.


Pre-existing conditions:

  1. Require assistance with any Activities of Daily Living (ADLs)
    • Transferring - Getting in and out of a bed or chair or car.
    • Continence - Letting go of your bladder or bowels without assistance, holding your bowels or using urinary continence assistance such as catheters.
    • Feeding - Needing help getting food or drink up to or into your mouth, cutting your food.
    • Dressing - Needing assistance putting on your clothes.
    • Toileting - Needing assistance to get onto and off of the toilet, wiping, washing up.
    • Bathing - Getting into and out of a shower or bathtub, needing help washing hair and/or body, drying oneself.
  2. Use of a wheelchair, oxygen, walker, crutches or multi-pronged cane.
  3. Daily care: assisted living or nursing home, adult day care or home health care.
  4. Incidental care: Needing help using a telephone, doing your banking or grocery shopping, or using transportation.


Some Pre-existing Health Conditions:

due to accident or degeneration

AIDs or HIV infection
Hemophilia (non- Von Willebrand disease)
Sickle Cell Anemia

Memory loss

Amyotrophic Lateral Sclerosis (ALS)
Multiple Sclerosis (Unless you are in the very early stages and do not require any walking aids or assistance of any kind.)
Parkinson's disease

Organ Degeneration:
Hepatitis C, Non-A, B, Non-B or Autoimmune (Active or Chronic)
Kidney failure
Liver Cirrhosis
Diabetes - treated with insulin

Post polio syndrome
Systemic Lupus Erythematosus

Genetic Degenerative diseases:
Cystic Fibrosis
Muscular Dystrophy



Other Considerations:

* Every LTC insurance company has different underwriting parameters, which can vary from state to state depending upon each state's laws.

* There may be a waiting period if you have had a stroke, heart attack or substance abuse within the last few years.

* There may also be waiting periods of various lengths if you have had certain surgeries recently. It depends upon the company, your recovery and state laws.

* Smoking or being overweight may affect the pricing of or ability to get LTC insurance.


Click Here Now to fill out the Long Term Care insurance contact form and plan your future with the assitance of an experienced LTCI specialist.