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Benefits with Commonwealth of Virginia Members

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Buying Long-Term Care Insurance

People with certain conditions may not qualify for long-term care insurance. Since standards vary between different insurance companies, if one company denies you, it is possible that another company will accept you. Common reasons why you might not be able to buy long-term care insurance include these:

  • You currently use long-term care services.
  • You already need help with activities of daily living (ADL).
  • You have AIDS or AIDS-related complex (ARC).
  • You have Alzheimer's disease or any form of dementia or cognitive dysfunction.
  • You have a progressive neurological condition, such as multiple sclerosis or Parkinson's disease.
  • You had a stroke within the past year to two years or have a history of strokes.
  • You have metastatic cancer (cancer that has spread beyond its original site).

Insurance companies also consider other health conditions when determining your eligibility. If you buy your long-term care insurance before you develop one of the health conditions listed above, then your policy will cover the care you need for that condition.

Before You Buy

You should consider a number of things before purchasing long-term care insurance:

  • Don't buy more insurance than you think you may need. You may have enough income to pay a portion of your care costs, and you may only need a small policy for the remainder. You also may have family members willing and able to supplement your care needs.
  • Don't buy too little insurance. That will only delay the use of your own assets or income to pay for care. Think about how you feel about having care costs that are not covered. While you can usually decrease your coverage, it is more difficult to increase coverage, especially if your health has declined.
  • Look carefully at each policy. There is no "one-size-fits-all" policy.
  • If you choose a policy that only pays for room and board in a facility, plan for other expenses, such as supplies, medications, linens, and other items and services that your policy may not cover.
  • It costs less to buy coverage when you are younger. The average age of people buying long-term care insurance today is about 60. The average age of those purchasing policies offered at work is about 50.
  • Make sure that you can afford the long-term care insurance policy over time, as your monthly income may change.
  • Research and consider different options, and talk with a professional before finalizing your decision.
  • Don't feel pressured into making a decision.

U.S. Department of Health and Human Services (HHS), Administration for Community Living (ACL), LongTermCare.gov. (Modified 2020, February 18). Buying long-term care insurance. Retrieved May 27, 2021, from https://acl.gov/ltc

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