While researching your Long Term Care insurance options, it is important to know if you are an eligible applicant for the Hybrid LTCI products. The first step after requesting your long term care quotes is a health pre screening discussion between you and your assigned insurance agent. The purpose for this initial conversation is to save yourself and your agent time because the last thing either of you want is to invest time and energy in researching something you might not meet the requirements to acquire.

What to expect:

After submitting your quote request form, you will be assigned a primary agent who will contact you to gain a little more information regarding your health history. Taking the simple steps of a health qualification check with your agent can save you and your agent a lot of time and make for an easier application process.

Questions your agent might ask:

1. Smoker or nonsmoker?
2. Have you seen your primary care physician within the last 2 years?
3. Are you currently taking any prescription medications? If yes, for what condition?
4. Do you have any planned surgeries in the coming months?
5. Have you had any surgeries recently that you are still being treated for and or in recovery from?
6. Are you in any physical, speech or occupational therapy?
7. Are you currently experiencing any symptoms of pain that you are being treated for?
8. Do you use any assistive devices such as a cane, walker or wheelchair?

Depending on the responses given by you, there may be additional health questions asked by the providers while we are pre-screening you for coverage. The more specific information you can provide will help us determine if you are eligible to apply for any of the hybrid long term care insurance products that are available.

Some medical conditions and medications are an automatic decline with the insurance companies. Keeping in mind there may be some exceptions to certain conditions, your agent can always reach out on your behalf to the carriers for more information regarding the circumstances in which the condition is declined.

Here is a list of some medical conditions that are an automatic decline due to their high risk factor or the unknown effects from ongoing treatment and associated medications.

Knockout conditions:

(This is not an exhaustive list of declinable conditions)

• ALS (Lou Gehrig’s disease)
• Cognitive impairment
• Dementia/Alzheimer’s
• Defibrillator
• Dialysis
• Cerebral Palsy
• Cancer (current or recent up to 2 years depending on type)
• Multiple Sclerosis
• Muscular Dystrophy
• Paralysis
• Parkinson’s disease
• Insulin dependent diabetes (for most carriers)
• HIV/AIDS
• Pending surgical procedures
• Receiving disability benefits

Nonmedical impairments that may result in a decline:

• Multiple DUI’s
• Current probation or jail
• Felony within the last 5 years
• Scuba diving greater than 130 feet
• Diagnostic testing planned, scheduled or recommended that has not been completed
• Use of a handicap permit due to physical limitations or medical conditions
• Planned, scheduled or recommended surgery that has not yet been completed
• Completed surgery, not yet fully recovered and not released from physician care related to the surgery

Medications being taken for these conditions that may result in a decline:

• Most pain management medications
• Dementia/Alzheimer’s
• Most steroids
• Multiple Sclerosis
• Cancer
• Blood disorders
• Parkinson’s
• Hepatitis
• Mental disorders such as bipolar, schizophrenia, paranoia and psychosis
• Drug and alcohol abuse
• Any/All medications for AIDS/ARC/HIV

The application process is quite simple and only takes about 15-20 minutes to step through together on a phone call or a shared screen interface meeting. We will initially send you a PDF copy of the application for the company/companies you will be applying with so you can be prepared for the questions asked during the call.

Pieces of information to have on hand during the call (differs between companies):

• SSN
• Drivers License
• State/or country you were born in
• List of any life/annuity/and or long term care policies in force and/or applied for within the last 12 months
• List of any insurance or annuity policies that lapsed within the last 12 months
• Beneficiary information: Full legal name, DOB, SSN and address
• Financial information: Annual income, household income, net worth, value of assets etc…
• List of physicians or medical facilities that have treated you within the last 5-10 years including addresses and phone numbers
• Names, dosages, usage and reason for use of prescription medications
• Any diagnosed medical conditions within the last 10 years and treatment
• Current and past use of tobacco/nicotine products
• Driving history

After completing the online application with your agent, you will then be emailed a link to review the application. While reviewing your application, make note of any incorrect information recorded on your application. If there are corrections to be made, do not sign your application – instead notify your agent so they can make the corrections and then resend the link for you to rereview. If your application is in good order, you can then sign and submit.

Your agent will perform a final review of your application and then add their signature and submit the application for underwriting.

The underwriting process typically takes 6-8 weeks from the time the application is submitted by your agent until a decision is made. Some companies offer expedited underwriting and your agent will be able to recommend this if they feel you meet the health requirements for this process. During the underwriting process, your agent will maintain communication with you by providing updates regarding your application status. If the company you applied with is requiring more information, the case manager will contact your agent with the required details and your agent will then contact you to collect the particulars. If at any time you have questions through this process please don’t hesitate to reach out directly to your agent for details.

The underwriting process typically takes 6-8 weeks from the time the application is submitted by your agent until a decision is made. Some companies offer expedited underwriting and your agent will be able to recommend this if they feel you meet the health requirements for this process. During the underwriting process, your agent will maintain communication with you by providing updates regarding your application status. If the company you applied with is requiring more information, the case manager will contact your agent with the required details and your agent will then contact you to collect the particulars. If at any time you have questions through this process please don’t hesitate to reach out directly to your agent for details.

What to expect during the underwriting process after you have submitted your application (varies between the companies):

• An email/phone call to schedule your Telehealth call within 24 hrs of submitting your application.
• Tele-interview usually lasts about an hour which is spent discussing your medical records and the answers you provided during the health questionnaire portion of the application. Depending on company and age, you may be subject to a cognitive assessment during your call.
• After the call they will order your MIB and RX files as well as a Physician Statement. Once the files are received, the underwriter will then take this time reviewing your health history. Underwriting decisions are typically reached within 1-2 weeks after this point.
• Some companies may require paramedical exams and labs so be sure to discuss this with your agent if this is of any concern.
• Once an underwriting decision is made 1 of 2 things will occur:

1. If approved, the contract will be issued and mailed for your review. There is a free look period of approximately 30-60 days (dependent on company and state regulations) for you to review and ask questions about your policy and make any corrections or amendments as needed before your premiums are due.
2. If declined, you will be sent a decline letter explaining the reasons for the decision and an appeals process.