LTC Case Help

[JGold814]

We've got a husband and wife - both interested in LTC coverage, but have some medical histories. Most carriers would look at both profiles as a decline for LTC (they qualified for life insurance), but wanted to see if anyone knows of any carriers who could offer LTC coverage with their med hxs. Please let me know if you have any ideas for programs they may qualify for.

Wife's med hx:
- 43 yo (age nearest 44)
- ht/wt 5' 7" 180 pounds
- been on depression medications for about 23 years (since 1987) - used to take buspar, zoloft, and wellbutrin - was switched to zyprexa, lithium, and prozac about 3 years ago. The DSM code for the condition on her medical reports is 296.36. Also takes Elestrin (HRT medication - taking for about 2 1/4 years) and Zantac (acid indigestion - over the counter medication). Family history is good.

Husband's med hx:
- 48 years old (age nearest 49)
-ht/wt 6' 1" 275 pounds
- Takes risperidone, effexor XR, divalprocxer, allopurinol, niaspan, alendronate, cabergoline, tramadol, klor-con, furosemide, colchicine, and testosterone injections. The prescriptions are for depression (diagnosed 1999), bipolar disorder (diagnosed 2002), hypercholesterolemia (diagnosed 2007), edema (diagnosed 2010), hyperprolactinemia & low testosterone (diagnosed 2004 - cause unknown), osteoporosis (diagnosed 2008), gout (diagnosed 2005), chronic back pain (diagnosed 2009 - cause unknown - received cortisone, anesthetic injections between 2010-2011). He also had bursitis both hips in 2009 and a hairline ankle fracture in 2007 (not related to the osteoporosis).

Thanks for everyone's help!

 

[ltcadviser]

The wife's UW issue is depression history controlled by medication. Lithium is main concern.

The husband's UW issues are bipolar disorder, osteoporosis, and chronic back pain.

No LTC underwriter will give a hoot about any of this other stuff....HRT, cholesterol, testosterone, acid indigestion, etc.

You do not need to discuss these issues with LTC UWs. They will fall asleep listening to all of this window dressing.

What state is the client a resident of?

 

[yankee466]

You might skate through on the wife if the meds are stable with someone like Mutual of Omaha....but still risky, You are likely toast with the husband with all the issues and overweight. Call it a domino effect if nothing else. Suggest wait for ObamaCare for him. Even United Security Assurance would likely not want him...and they are last resort in most cases. Anyone on disability?

My guess is that there is even more in the medical records than you know. Good luck on this one. Hopefully others will chime in.

 

[CALTCAgent]

Curious, what rating did they get for the life insurance?

 

[ltcadviser]

You might skate through on the wife if the meds are stable with someone like Mutual of Omaha....but still risky, You are likely toast with the husband with all the issues and overweight. Call it a domino effect if nothing else. Suggest wait for ObamaCare for him. Even United Security Assurance would likely not want him...and they are last resort in most cases. Anyone on disability?

My guess is that there is even more in the medical records than you know. Good luck on this one. Hopefully others will chime in.

Yes, Herman. That's why I was curious as to the State of Residence just to see if United Security is even a remote possibility.

 

[TwiLight]

More than one med for Bipolar and Depression is a knockout for most of the STC/Recovery plans also.

Your best bet is something is better than nothing and go with the Kemper HHC plan, which they would qualify in Virginia. MD is not an approved State for Kemper HHC.

 

[ltcadviser]

Maybe Forethought ForeCare LTC annuity?

 

[yankee466]

More than one med for Bipolar and Depression is a knockout for most of the STC/Recovery plans also.

Your best bet is something is better than nothing and go with the Kemper HHC plan, which they would qualify in Virginia. MD is not an approved State for Kemper HHC.

I would be careful with that approach...since Kemper is really not a HHC plan.....and really not much better than nothing. It is really a plan intended to supplement a MAPD plan becuase of the co-pays and MOOP for professional services at home. True home health features (caregiver) are basically non-existent in the product if you read the fine print. I guess that is a debatable point of course, since it is cheap for what you get.

 

[TwiLight]

I would be careful with that approach...since Kemper is really not a HHC plan.....and really not much better than nothing. It is really a plan intended to supplement a MAPD plan because of the co-pays and MOOP for professional services at home. True home health features (caregiver) are basically non-existent in the product if you read the fine print. I guess that is a debatable point of course, since it is cheap for what you get.

You are trying to compare Apples vs Oranges.

KemperHHC is not a True Standalone HHC in regards to caregiving and has a limited benefit of 60 days except for TX (365 days). If the insured could qualify for LTC it would be better for them.....They cannot. So, allowing some of the costs that may be duplicated in a MAPD or any other plan that is Medicare approved or Medicare itself is actually a good thing. The plan is a CASH indemnity plan and the insured could use the funds received for any purpose.

I do miss the true Standalone HHC plans. This is the only one that is similar and available that is A- Rated or better.

You will find for those not in the upper 10% of income will agree that SOMETHING is better than nothing.

 

[Tahoe Ray]

Maybe Forethought ForeCare LTC annuity?

Probably a standard rating...could be the only option if they have a lump sum.