Can You Buy Long-Term Care Insurance at Any Age?

Long-term care insurance (LTC) is a financial product designed to help cover the costs associated with extended personal and custodial care. This care is generally not covered by traditional health insurance, Medicare, or Medicaid, and can include services provided in a nursing home, assisted living facility, or even within one’s own home. While there isn’t a universal age limit for LTC insurance, eligibility and practical considerations related to an individual’s age, health, and financial standing influence policy approval.

Eligibility and Age Considerations

Insurers use age bands and underwriting to evaluate applicants for long-term care insurance. While it is technically possible to apply at various ages, a common period for purchasing a policy is between ages 50 and early 60s. This timeframe is considered a “sweet spot” because it balances the likelihood of being in good health with more manageable premium costs.

The applicant’s age impacts premium costs, which generally increase with age. This is because the probability of needing long-term care rises with age. For instance, a 55-year-old individual might pay a significantly lower annual premium compared to someone purchasing the same coverage at age 65. A 55-year-old man might pay around $950 annually for a policy with $165,000 in benefits, while a 65-year-old man could pay approximately $1,700 for the same coverage. Similarly, a 55-year-old woman might pay about $1,500 annually, which could increase to $2,700 at age 65.

Beyond premiums, age also plays a role in health underwriting, as older individuals are more likely to have pre-existing conditions that could influence eligibility or result in higher premiums. Insurers assess an applicant’s health at the time of application, and the incidence of health issues tends to increase with age. While some policies may be available to individuals over 65, the possibility of being declined also rises with age. Some insurance companies maintain age caps, often around 75 to 80, beyond which they may not issue new policies. Conversely, very young applicants, such as those in their 20s or 30s, might find it less financially practical to purchase coverage due to the distant need and long premium payment period.

Factors Influencing Policy Purchase

Current health status is a primary determinant for long-term care insurance, regardless of age. Insurers assess medical history, and certain health conditions can lead to higher premiums or denial. Common conditions that may impact eligibility include chronic illnesses such as diabetes, heart disease, or any existing cognitive impairment like early-stage dementia. Individuals already receiving or in immediate need of long-term care services are typically ineligible for new policies.

An individual’s financial situation also influences the decision to purchase long-term care insurance. Affordability of premiums is a consideration, as these costs are ongoing and can increase. Financial advisors suggest considering LTC insurance if one has at least $250,000 in assets, excluding their primary residence, to ensure manageable premiums. For some, self-insuring, where personal savings and investments are designated to cover future care costs, might be a viable alternative if substantial assets are available.

The type and amount of coverage desired also affect policy purchase decisions and costs. Policyholders select a daily or monthly benefit amount, the maximum the insurer will pay for care. The benefit period, the length of time the policy will pay out, also varies, with some policies offering coverage for a few years and others for a lifetime. Additional features, such as inflation protection (which helps the benefit amount keep pace with rising care costs) and the elimination period (which is the number of days one must pay for care out-of-pocket before benefits begin), further customize a policy and influence its premium.

The Application and Underwriting Process

Obtaining long-term care insurance begins with gathering information about available providers and policy options. This initial research helps individuals understand the various types of coverage and features offered by different insurers. Understanding the general requirements and potential costs involved is an important first step before committing to an application.

Once a suitable option is identified, the next step involves submitting a formal application to the chosen insurance provider. This application requires comprehensive personal details, financial information, and extensive health-related disclosures. Applicants must accurately provide their medical history, including any past or present conditions, medications, and treatments, to allow the insurer to assess their risk profile.

A critical phase of the application is health underwriting, where the insurer evaluates the applicant’s health to determine eligibility and set premium rates. This process typically involves reviewing medical records, which requires the applicant’s consent for release from healthcare providers. Insurers may also conduct a phone interview with a nurse or other medical professional to clarify health information or ask follow-up questions. In some cases, a physical exam or a cognitive assessment might be required to further evaluate an applicant’s health status. These assessments aim to confirm the information provided and identify any underlying health concerns.

Following the underwriting review, the insurer makes a decision regarding the policy. The application may be approved as submitted, approved with modifications such as a higher premium or reduced benefits, or declined entirely. If approved, the policy document is issued, detailing the coverage terms, benefits, and premium schedule. It is important for the policyholder to thoroughly review this document to ensure it aligns with their expectations and financial planning goals.