“abnormal MRI” and long-term care insurance

I’ve helped several people who have been declined for long-term care insurance because they had an “abnormal MRI”.  Why would an “abnormal MRI” be a reason someone could be declined for long-term care insurance?

Over 30% of claims on long-term care insurance policies are because of dementia or Alzheimer’s.  Some long term care insurers believe that an “abnormal MRI” is a possible precursor to dementia or Alzheimer’s.

The good news is that not all long term care insurers think that.

Recently, we worked with a very healthy woman in her early sixties.  She works full-time.  She has no significant health issues, except for some treatment for mild depression a few years back.  She is not taking any prescription medications.  She has not been hospitalized nor had any type of surgery in the last ten years.  She has no history of cancer, nor diabetes, nor heart disease.  She has no history of tobacco use and she is not overweight.

However, she did have migraine-like symptoms a few years back and was given an MRI.  The MRI showed some “signal abnormalities” in her brain with the possibility of “chronic small vessel disease”.  She was declined by one of the top ten long term care insurers because of the MRI results.   A few other insurers told us that they could not even consider an application.  A couple of the top LTC insurers said that they would consider insuring her if she had another MRI which definitively ruled out “chronic small vessel disease”.

2 of the top 10 long term care insurers said they would consider an application right now.  We submitted applications to both of those companies.  One of them declined her and one approved her with their “standard” rates.  The insurer that approved her has high financial ratings; and this insurer has one of the best track records in the LTC insurance industry for claims payment and premium stability.

Remember:

• Every long term care insurer has a different way of looking at health history
• Just because you’re declined by one long term care insurer, does not mean you can’t get approved by another.

Scott A. Olson

One woman–3 different outcomes with long-term care insurance

Recently one of my associates asked me about a woman he was working with who had been declined for long term care insurance.  She’d applied for coverage with a company that her financial advisor had recommended for her and she was declined because of “sticky platelet syndrome” (SPS).  “Sticky platelet syndrome” is a blood disorder that is usually treated with blood thinners like plavix or coumadin or aspirin.

After discussions with several underwriters with some of the top long term care insurers, I recommended to my associate that she apply for long term care insurance with two of the leading long term care insurers.  Fortunately, both of them approved her.

One of them approved her with “substandard” rates (which are about 25% higher than their standard rates.)  That insurer also decreased the amount of benefits she had applied for.  She wanted a very long Benefit Period, but they approved her for a little more than half of what she had applied for.

On the other hand, the other insurer approved her with all of the benefits she had requested.  Also, since  she had no other health issues and she met the “preferred criteria” for the second insurer, they approved her with the “preferred health discount”.

What are the lessons to learn here?

1)  Just because you’ve been declined by one long term care insurer, does NOT mean that you’ll be declined by all.

2)  Each of the top ten long term care insurers has a unique way of looking at your health history.  Whichever insurance agent you work with, make sure that he or she knows the unique “underwriting nuances” that each company has.

3)  Just because one long term care insurer approves you with a “substandard” rate, does not mean that they all would.  Each long term care insurer has a unique way of determining who can qualify for the ‘preferred’, ‘standard’, or ‘substandard’ rates.

Stability in your health is what’s most important to qualify for long-term care insurance

You do not have to have a perfect health history in order to qualify for long term care insurance.  But your health history does have to be relatively stable.

I’ve helped hundreds of people with health problems obtain long term care insurance from high quality insurance companies, at reasonable rates.

Many of my clients have had health histories that included:  hepatitis, most kinds of cancer (including melanoma), sleep apnea, type 2 diabetes, insulin-dependent diabetes (IDDM), rheumatoid arthritis (RA), fibromyalgia, transient ischemic attack (TIA), heart surgery, carotid artery disease, chronic fatigue syndrome, implantable automatic defibrillator (IAD), emphysema (COPD), osteoporosis, thyroidism, ulcerative colitis, certain types of lupus, pacemaker recipients, pancreatitis, sarcoidosis, epilepsy, and many other health issues.

You are probably thinking, “Those are serious health conditions.  Why would a long term care insurer be willing to insure someone with one or more of those health conditions?”

The reason:  Stability.

Many people can have one or more of these conditions and live strong, independent, fulfilling lives for decades.  Advances in medicine are enabling many people to live full lives and to manage chronic health conditions.

If your chronic health condition is being managed well and is relatively stable, you should be able to qualify for long term care insurance.

Keep in mind:  stability is the key!

Do NOT do the following:

A couple years ago, I was contacted by someone who had some elevated liver functions.  His condition was stable.  He was taking medication for it.  I recommended one of the leading long term care insurers for him.  I didn’t hear back from him for awhile.  I followed up via e-mail and he told me that his condition had gotten worse.  He said that he decided to stop taking his medication because he wanted to try to qualify for a “preferred rate” for long term care insurance.  He figured that if he stopped taking his medication for a few months that he could get a “preferred rate”.  After stopping the medication he had a relapse.

Here’s the rub:   The difference in premium between the “preferred” rate and the “standard” rate was only 10%!!!  He risked his health to try to save about $15 a month.  But, even if he hadn’t had a relapse, he still would not have been able to get the “preferred rate”.  In order for him to get the “preferred rate” from this insurer he would have had to have been off the medication and have normal liver function tests for 5 years!

If he’d asked me ahead of time, I would have been able to tell him this.  But, he didn’t.

It’s okay if you have a chronic health condition.

Is there hope for someone who has been declined for long-term care insurance?

I was reading an online “newspaper” the other day.  There was an article about long term care insurance and the importance of planning for the financial consequences of needing long term care.

I like to read the comments at the end of articles.  I often find the comments more interesting than the article itself.  I was surprised that a number of people left comments believing that only those with “perfect health” could qualify for long term care insurance.  Nothing could be further from the truth!

Since 1995 I’ve helped hundreds of people with health problems obtain quality long term care insurance policies, from highly rated insurers, at affordable prices.  The key is knowing each long term care insurer’s “underwriting nuances”.

For example, one long term care insurer might not insure someone who has had a Transient Ischemic Attack (aka T.I.A. or “mini-stroke”) in the past 5 years.  Whereas another long term care insurer can insure someone who has had a “mini-stroke” just 12 months ago.

An application submitted to the first insurer would result in an automatic declination.  An application submitted to the second company would most likely be approved.

This is an over-simplified example, but it illustrates the central point:  Most of the leading long term care insurers have very different ways of determining who is insurable and who is not insurable.

Is there hope for someone who has been declined for long term care insurance?  ABSOLUTELY!