Kookaburra wrote: ↑Wed May 19, 2021 6:17 pm
Can anyone provide clarity on what medical underwriting associated with application for private LTC policies involves? This is a new area for me. Does it involve being examined by a physician, filling out a form, other?
It depends. There are many different types of medical underwriting for long-term care insurance.
"Modified Guaranteed Issue" is the easiest to qualify for. It's what Microsoft and some other large companies are offering their employees through Transamerica. If you can answer "yes" to 3 simple questions you are automatically approved. Two of the questions have to do with your work attendance. They figure that if you can work at least 20 hours per week then you are not likely to go on claim anytime soon. Policies with this type of underwriting usually have very low limits: e.g. $100 daily maximum, $50,000 lifetime maximum, etc... Also, spouses are usually not allowed to apply for a policy like this UNLESS the spouse is also an employee of the company.
"Simplified Issue" is also easy to qualify for. It requires a short application with a dozen or so health questions. As long as you can answer "No" to the health questions and as long as you're not obese, you're pretty much guaranteed approval. There are no medical records required. No medical exams. Since the underwriting is very simple it usually has a daily maximum of $250 or less and a lifetime maximum of about $90,000 or less.
"Jet Issue" is underwriting that is based solely upon a telephone interview with a "nurse assessor" who works for the insurance company. The phone interview usually lasts 45 minutes or more. If you're very healthy you can be approved with just this phone interview. No medical records are required. No medical exams are required. However, if the "nurse assessor" finds some aspects of your health history that require further evaluation, you'll have to go through "Full Underwriting".
"Full underwriting" requires a review of your medical records from your primary care doctor and any specialists you see regularly. It can take a very long time to get medical records copied and then sent to the insurance company (sometimes 2 to 3 months). Most long-term care insurance applications are "fully underwritten". If you want very rich benefits, you'll most likely need to go through "full underwriting".
As we get closer to the deadline more and more people will opt for policies that have "simplified issue" because it will take too long to get approved for a "fully underwritten" policy.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.