Declined for Long-Term Care Insurance? Here’s What to Do Next
You finally take the step to protect your future—applying for Long-Term Care Insurance to safeguard your income and assets, avoid being a burden on your loved ones, and ensure access to quality care. But then, you get the bad news: your application was declined.
It’s a situation more common than many realize, particularly if you didn’t work with a Long-Term Care Insurance specialist. Even with expert guidance, though, a decline can still happen.
But don’t panic. A decline is not necessarily the end of the road; it is often just the beginning of your journey.
Why You Might Be Declined for Long-Term Care Insurance
Each insurance company uses its own underwriting guidelines. That means a health issue that results in a decline with one company might be accepted by another.
Here are the most common reasons people are denied coverage:
1. Health History
Chronic or serious health conditions—especially if untreated or unstable—can lead to a decline. Common examples include:
- Uncontrolled diabetes with complications
- History of stroke or heart attack within the past 12–24 months
- Cancer within the past few years (depending on the type and stage)
2. Ongoing Medical Treatment
If you're actively undergoing treatment for a condition like cancer, autoimmune disease, or certain mental health issues, insurers may postpone or decline coverage.
3. Recent or Upcoming Surgery
Scheduled surgeries or recent major procedures often put your application on hold. Insurers typically require a waiting period (commonly 3–12 months post-op) before reconsidering.
4. New Medications
If you’ve recently started a new medication—especially for depression, anxiety, heart disease, or neurological conditions—the insurer may wait to assess stability before approving coverage.
5. Uninsurable Medications
Some prescription drugs automatically disqualify applicants. These often include medications for:
- Memory loss or dementia
- Parkinson’s disease
- Multiple sclerosis
- Certain high-risk psychiatric medications
Each insurance company maintains a list of medications it considers uninsurable; therefore, working with a specialist who is familiar with these lists is key.
6. Cognitive or Memory Issues
Failing a cognitive assessment (such as the Minnesota Cognitive Acuity Screen or similar tools) will almost always result in a decline. These assessments are typically required for applicants over 60.
7. Age Limits
Most companies will not accept new applicants over age 75 or 79, although this varies by insurer. Starting the process in your 50s or early 60s is ideal. There are products available for older adults, but the options are very limited.
8. Family History (in some cases)
A few insurance companies may consider your family history—particularly multiple first-degree family members with Alzheimer’s or dementia—as a risk factor.
What to Do if You're Declined
A decline doesn’t always mean you’re ineligible for coverage. Here's what typically happens next if you're working with a qualified Long-Term Care Insurance specialist:
1. Verify the Accuracy of the Decision
Insurance decisions are often based on your medical records. These records can contain errors, outdated information, or misdiagnoses. An experienced specialist will first request a copy of the underwriting report and help you identify and correct any inaccuracies.
2. Request Reconsideration
In borderline cases, a specialist can advocate on your behalf and ask for reconsideration. This might involve submitting updated physician letters, additional test results, or clarification of your health history.
3. Explore Other Companies
Not all insurance carriers underwrite the same way. A specialist knows which insurers have more lenient standards for specific conditions and may pivot your application to a more suitable company.
"Depending on the health issue, it's not uncommon to get a 'no' from one carrier and a 'yes' from another," says Cassandra Watson, President of Platinum LTC Solutions, a brokerage general agency focused exclusively on long-term care.
Knowing the nuances of each company's underwriting makes all the difference, and that's where a specialist can truly advocate for you. This is especially important if you were declined a while ago. Long-term care specialists have the experience and know-how to advise you on the best course of action today, all with the goal of helping you to get coverage.
You can share your thoughts and experiences about aging, caregiving, health, and long-term care with LTC News — Contact LTC News.
Options if You're Not Eligible for Traditional LTC Insurance
If traditional Long-Term Care Insurance is off the table, other solutions may still work for your needs. These include:
1. Hybrid Long-Term Care Policies
These products combine life insurance or annuities with long-term care riders. A few offer more lenient underwriting and accept applicants who were declined by other insurance companies.
One company will approve almost anyone, but the underwriting will decide the amount of long-term care benefit that will be available. The underwriting process involves a video interview, during which they can ask you questions and assess your ability to move around.
Premiums for these products are often paid as a lump sum or over a set number of years.
2. Short-Term Care or Cash Indemnity Policies
These plans provide limited long-term care benefits—usually up to 12 months—but can still offer valuable support. Underwriting is typically easier, based on your medications and answers to a series of health questions. The benefits are paid as a daily or weekly cash amount, regardless of actual care costs.
Linda Weyer, a Long-Term Care Insurance specialist licensed in several states, says these plans can deliver robust support, even for those with pre-existing health issues, making traditional coverage unattainable or too expensive.
So-called short-term care insurance plans may only pay benefits over a limited period, but they offer powerful protection when it's needed most—covering care at home or in a facility of your choice with flexible, affordable options.
3. Critical Illness or Chronic Illness Riders
Some life insurance policies include riders that allow you to access a portion of your death benefit if you’re diagnosed with a qualifying chronic illness. These riders don’t replace long-term care insurance but can help bridge the gap.
The Importance of Specialist Guidance
It is essential when starting the long-term care planning process to note that every insurance company has different underwriting guidelines. That’s why working with a qualified Long-Term Care Insurance specialist who represents all the major insurance companies that offer long-term care solutions is essential.
These specialists will ask detailed questions about your health, medications, surgeries, and family history to determine the most appropriate insurance company before applying — something most financial advisors and general insurance agents fail to do, or are uncomfortable doing.
If you are speaking with an agent about Long-Term Care Insurance and they are not spending a lot of time asking questions about your health and family history, then most experts say, find someone else.
LTC News doesn't sell insurance (we do sell advertising - Advertise With Us | LTC News), but we do have vetted Long-Term Care Insurance specialists that we can forward your request to. The trusted specialists partnered with LTC News are among the most respected independent experts in the long-term care planning industry.
Each has been carefully vetted for experience, integrity, and results. Many hold the prestigious Certified in Long-Term Care (CLTC) designation, demonstrating advanced knowledge in helping individuals and families navigate the complexities of long-term care.
These specialists have been endorsed by the American Association for Long-Term Care Insurance (AALTCI), recognized as Ramsey Trusted Pros by Dave Ramsey’s organization—indicators of their professionalism and ethical standards. Several also maintain close affiliations with Christian and Jewish organizations, underscoring their commitment to values-based service and community trust.
If you are an LTC Insurance specialist and want to be added to our list, contact LTC News - Contact LTC News.
Trying to apply through a general insurance agent or financial advisor often results in avoidable declines—and missed opportunities.
Key Takeaways
- Being declined doesn’t necessarily mean you’re uninsurable—it means more information or a different approach may be needed.
- A specialist can help correct errors, request reconsideration, or find a better-fit policy.
- Alternative options, including hybrid policies and short-term care insurance, are available.
Don’t Wait Until It’s Too Late
The bottom line is that your health, body, and mind change as you age. Even what you think are minor changes in your health can make a significant difference in eligibility and premiums.
Starting your planning in your 40s, 50s, or early 60s gives you the best chance to secure affordable and comprehensive coverage. However, no matter what your current age, a qualified LTC Insurance specialist can often find you an affordable solution.