How to Handle a Long-Term Care Insurance Decline

person in suit denying cash
Katie Camann
Katie Camann January 6, 2022

As Content Marketing Specialist, Katie drafts and edits content across multiple platforms, including blogs, Industry News, emails, videos, website pages, and more. She conducts research and gathers up-to-date information to keep our clients well-informed.


Disclaimer: Since Medicaid rules and insurance regulations are updated regularly, past blog posts may not present the most accurate or relevant data. Please contact our office for up-to-date information, strategies, and guidance.

Long-Term Care Insurance (LTCI) is one of the best ways to cover a long-term care stay. Individuals can curate their LTCI policy to fit their specific budget and circumstances while also achieving peace of mind that their future care costs will be covered. However, in order to qualify for LTCI, individuals must meet certain criteria and can, therefore, be declined coverage.

How to Qualify for LTCI

LTCI is available for individuals in good health standing who are below age 86 for hybrid policies or below age 79 for traditional policies. Although health can be somewhat subjective, your client may be a good candidate for LTCI if they:

  • Have never been prescribed a handicap sticker
  • Do not require help with any Activities of Daily Living (ADLs)
  • Have never been diagnosed with AIDS, HIV, or ARC disorders
  • Have never been diagnosed with or presented symptoms of Alzheimer’s disease, dementia, memory loss, multiple sclerosis, muscular dystrophy, ALS (Lou Gehrig’s disease), or Parkinson’s disease
  • Are capable of walking four blocks or climbing two flights of stairs

Because of these health and age restrictions, it becomes harder for people to qualify for LTCI as they age. In fact, there has been a 53.6% decline for applicants who are age 75 and older. The unfortunate reality is most people don’t want to think about needing long-term care until it’s too late to plan properly and they are no longer eligible for LTCI.

Don’t let the fear of being declined coverage prevent your client from exploring LTCI. We offer complimentary anonymous pre-screening to determine whether your client would likely qualify for a policy. Contact our team to learn more.

What to Do If Your Client is Declined an LTCI Policy

So, what do you do if your client is declined Long-Term Care Insurance coverage? Unfortunately, many insurance advisors and financial planners don’t offer options other than LTCI for helping clients plan for their long-term care.

That’s where we come in. The old saying, “Failing to plan is planning to fail,” doesn’t have to be true here. At The Krause Agency, we specialize in helping seniors protect their hard-earned assets from a long-term care stay, even if they have not planned ahead by purchasing LTCI.

The Solution: A Medicaid Compliant Annuity

In the event your client does not qualify for an LTCI policy, we offer another innovative product to safeguard their assets. Suppose you have a client who didn’t plan ahead or qualify for LTCI who is already in or about to enter a nursing home. In that case, you can use a Medicaid Compliant Annuity to spend down their assets, protect their savings from the nursing home, and accelerate their eligibility for Medicaid benefits.

Interested in learning more? Schedule a Discovery Call with one of our in-house advisors to discuss your client’s specific situation and find out how you can help them overcome an LTCI decline and protect their hard-earned assets in the process.