“I’ve had a heart attack; am I eligible for Long Term Care Insurance?” This is a common question I am asked from both consumers and the insurance professionals I work with. The “HEART” of the matter (pun intended), is that very often only after a health issue occurs are we reminded of the reality of our mortality and seek advice on planning to protect ourselves and our loved ones against the risk we are facing. We ‘should’ also be reminded of the reality of our morbidity. Let’s face it; our culture often encourages us to ignore both – especially the morbidity aspect, hence our failure to properly plan to live a long life. The answer to your question however – whether you are eligible for Long Term Care Insurance- is not simple.
Morbidity versus Mortality
The underwriters for Long Term Care Insurance are more concerned with Morbidity than Mortality; it’s about your having a health issue you will ‘live with’ rather than whether the condition will cause a premature death. Long term care expenses occur when you are living but you are no longer able to function independently and you need assistance with your activities of daily living or “ADL’s” (bathing, dressing, feeding, transferring, toileting, continence) OR you need assistance or supervision due to a cognitive impairment. LIFE insurance is about mortality and whether your health is more likely to cause death prior to life expectancy. If you survive a heart attack, it’s more likely you will recover to full functioning, even if it takes a period of time to recover. This would be looked at more favorably from the underwriters once the recovery period is over and your health is stable. If your heart condition is the only health issue you have, I predict you would be eligible for long term care insurance after this recovery period that will depend on what your ‘heart event’ was, what the treatment was and when it occurred.
Heart Disease and Secondary Health Issues
The challenges with heart disease and eligibility for LTCi (Long Term Care Insurance) most often occurs when you have another health issue in combination with the heart incident. This is known as “Co-Morbidity” and is when you have more than one health condition that puts you at higher risk of losing your independence and needing assistance with your activities of daily living. If your only health issue is the heart attack, as an example, and it was successfully treated – such as with angioplasty or stent – usually after a ‘recovery period’ and release from your doctor’s care, the underwriter would approve you for LTC insurance. However if you have a heart attack and perhaps you are a diabetic, or possibly you have had a TIA (transient Ischemic Attack – also known as a mini stroke) or maybe you have a recent history of tobacco use, this Co-Morbidity increases your risk therefore the underwriter will be more strict in determining whether to make an offer or decline an offer for coverage.
How to Determine Your Eligibility
As noted, there is no easy answer. My advice is to allow me to complete a “pre-qualification assessment”, which is a complimentary service. Once I have gathered some basic information which includes specific details of your medical history, I will be able to communicate with the underwriters at each carrier and determine if they are willing to consider you for coverage. I work with 10 of the top LTC insurance carriers which allows me to find and recommend the right one for you. In this case, the ‘right’ one would be the carrier most willing to consider you for coverage based on your health status. This “pre-qualification” is not a guarantee for coverage but it is the carrier’s agreement to accept your application for consideration. If you are interested in discussing your eligibility and what options could be available please contact me via my website: www.LTchoices.com, via email:Peggy@LTchoices.com, or by phone: 770.314. 3705.