Long term care insurance no medical exam

Please note that this article is meant to educate and clarify some of the terms used by life insurance companies. Only existing Nationwide® Property & Casualty insurance members can currently purchase a simplified whole life policy without a medical exam. However, Nationwide's underwriting process also allows qualified healthy applicants to bypass a medical exam on all other life insurance policies.

Life can be complicated. So when you find a way to simplify the complex — especially for something as important as buying life insurance — it’s only natural to be curious.

Many companies today offer no-exam life insurance as a fast and noninvasive way to get the protection you need. Like most things in life, though, there can be benefits and limits that you need to consider before choosing a product.

What is no-exam life insurance?

Traditional life insurance requires a medical exam to help give the insurance company a better picture of your health. This process includes collecting data such as:

  • Height
  • Weight
  • Blood pressure
  • Blood and urine samples
  • Possibly an EKG

As the name implies, no-exam life insurance can issue a policy to you without needing to go through this process, drastically reducing what can sometimes be a lengthy ordeal.

How does it work?

Three types1 of no-exam life insurance are available, each with their own unique benefits and limits.

Accelerated underwriting policies

Companies that offer these products use the data you provide, as well as third-party data and algorithms, to decide if they should offer you coverage or not. They offer the convenience of not having to complete an exam while still providing rates similar to products requiring full underwriting. However, they usually also have coverage limits (often $1 million) that can make this choice less appealing if you need more protection.

Simplified issue life insurance

For this type of product, there are typically fewer questions to answer and fewer resources used to collect your data. But because the company has less information to go on, you’ll likely end up paying more for your insurance. These products also have coverage limits that you’ll need to be aware of prior to applying.

Guaranteed issue life insurance

With this type of product, you’re guaranteed coverage, as the name suggests. There is no exam and there are no questions to answer, with age generally being the only restriction. These policies offer very limited coverage (typically about $25,000) and will cost much more than traditional life insurance. They are most often used by older people (or those in poor health) as a way to help their loved ones pay for final expenses.

BenefitsLimitationsAccelerated underwritingFast
Noninvasive
Competitive ratesLimited coverage amountsSimplified issueFast
NoninvasiveHigher rates
Limited coverage amountsGuaranteed issueYou can’t be turned downExpensive
Limited coverage amounts

Is no-exam life insurance right for you?

As more and more companies offer coverage (especially term life) with no medical exam, you gain more control over how long the process will take and how invasive it’ll be. While each type of no-exam life insurance has its benefits, they also have limits to consider.

It’s also important to remember that traditional life insurance can often offer you a lower rate because it’s based on your unique health and lifestyle. And most companies, including Nationwide, have simplified the medical exam and underwriting process to make them as painless as possible.

Knowing how much coverage you need, how much you want to pay and how long you’re willing to wait for coverage will help you choose the best type of life insurance product to meet your needs.

Long-term care insurance can cover the cost of ongoing medical services or help for a chronic medical condition or after an injury or medical event.

  • The cost of long-term care insurance depends on several factors. These factors include your age and health when you buy the policy, your gender, and where you live.

  • Insurers require you to take a health exam before they sell you a long-term care policy.

  • Long term care insurance no medical exam
    FG Trade/E+ via Getty Images

    While not everyone will need long-term care in their life, it’s common — and expensive — enough that people planning for retirement should account for it. Buying long-term care insurance is one way to protect your finances. 

    What does long-term care insurance cover?

    Millions of Americans rely on long-term care insurance to help them pay certified nursing aides and other attendants who give day-to-day care. That care may involve providing medical services after an injury or health-related incident, or tending to someone with a chronic illness. The care may simply be assistance with activities of daily living — everything from getting in and out of bed to feeding yourself. 

    Most traditional health insurance plans don’t cover such services. Neither do Medicare, Medicaid, or Affordable Care Act (ACA) marketplace insurance policies. Long-term care policies typically include:

    • A set daily benefit, which limits the amount the policy will pay per day.

    • A lifetime cap, which limits the amount the policy will pay out in total.

    Some policies allow beneficiaries to use their benefits to pay family members who are taking care of them. 

    Depending on your budget, preference, and needs, long-term care can take place in different places with different types of caregivers. You may choose: 

    • “Aging in place” at home with family or live-in help

    • Daily senior care at an adult care center

    • Care at a residential facility such as an assisted living community or a nursing home

    The cost of long-term care varies widely. Nationwide, the median cost of having a home health aide is about $4,500 per month, while the median cost of a private room in a nursing home is $8,800 per month, according to Genworth’s Cost of Care report. These costs may be higher or lower for you depending on the amount or type of care that you need and the area you live in.

    What doesn’t long-term care insurance cover?

    Long-term care insurance does not cover medical services for acute injuries or illness; traditional health insurance generally covers those. Some long-term care policies also restrict coverage for services related to pre-existing conditions. The restrictions might last for the life of the policy or merely for a period of time (such as 6 months) after purchase. 

    Does Medicare pay for long-term care?

    Medicare provides limited long-term care coverage in specific situations. If you go to a skilled nursing facility after a 3-day hospital stay, Medicare will pay all costs for the first 20 days you spend there. Starting on day 21, you’ll owe $185.20 in coinsurance per day. As of day 101, Medicare coverage ends, and you are responsible for all costs. That coverage will reset after you’re released from the hospital and remain out for at least 60 days.

    Medicare will also cover home health care for up to 28 hours per week. The benefits last as long as you need skilled care; your doctor will have to certify your plan of care every 60 days.

    How much does long-term care insurance cost?

    The cost of long-term care insurance depends on several factors, including:

    • Your age

    • Your gender

    • Where you live

    • How healthy you are when you purchase the policy

    The price will also reflect your level of benefits, such as:

    • The amount of your deductible 

    • The amount of your daily benefits

    • Whether you choose an inflation rider, which adjusts your benefits as prices go up

    In general, women pay higher rates, since they live an average of 2.6 years longer. But couples who buy a plan together may pay a lower combined premium than if they purchased separate policies. That’s because spouses often provide unpaid care to each other, potentially reducing their claims.

    Typically, the younger you are when you sign on to long-term care insurance, the cheaper it is. But if you purchase a plan at a very young age — even accounting for the lower premium — you could end up paying more over time, due to extra years of monthly payments.

    As with life insurance, you’ll likely need a medical exam when you apply. You may pay higher premiums (or be denied entirely) based on the results of that exam. This is called medical underwriting.

    Here’s a look at the current averages for long-term care insurance premiums in the state of Illinois, according to the American Association for Long-Term Care Insurance. These prices would be for healthy applicants buying a policy that’s now worth $165,000.

                                                       Benefit growth over timeYearly premium for policy purchased at age 55*Benefit value after 30 years (at age 85)Yearly premium for policy purchased at age 65*Benefit value after 20 years (at age 85)Single male0% (level benefit)$950$165,000$1,700$165,000Single male3% increase in benefit per year$2,220$400,500$3,135$296,000Single female0% (level benefit)$1,500$165,000$2,700$165,000Single female3% increase in benefit per year$3,700$400,500$5,265$296,000Couple0% (level benefit)$2,080, combined$165,000 each$3,750, combined$165,000 eachCouple3% increase in benefit per year$5,025, combined$400,500 each$7,150, combined$296,000 each

    *Assumes couples are the same age when purchasing the policy.

    The best age for most people to buy long-term care insurance is between 60 and 65. That’s when you’re young and healthy enough to qualify for a plan with a relatively affordable premium. But you're also old enough that you won’t be paying a decade’s worth of premiums for a service you’re unlikely to use.

    Current projections say that 20% of 65-year-olds will never need long-term care. Another 20% will need only minimal care, according to research from Boston College.

    If you are among this 40% and you never file a claim, you won’t ever get a benefit from having long-term care insurance — aside from peace of mind. That’s why some insurers now offer hybrid policies that combine life insurance and long-term care insurance. These plans are pricier, but if you die without using the long-term care benefit, your heirs will receive a payment.

    What level of care do I need based on my health?

    Remember, you’re purchasing insurance for care you’ll need in the future, not right now. You may need to sign up for a higher level of coverage if:

    • You already have chronic conditions.

    • Chronic conditions run in your family.

    • You know you’ll prefer private care when the time comes.

    Health isn't the only factor to consider. You'll also need to think about your finances. You may need less (or no) long-term care insurance if you have a health savings account or other savings earmarked for healthcare costs in retirement. If you have very few assets, you may be able to rely on Medicaid. 

    How many years do I need covered?

    On average, women who need long-term care need it for 3.7 years, and men need it for an average of 2.2 years, according to the U.S. Department of Health & Human Services. So, policies that cover 3 to 5 years should suffice.

    How much help will I get from unpaid caregivers?

    Most people who receive long-term care get it from unpaid family members. Unfortunately, that can cause financial strain on the family members who take time off work to do the caregiving. If you expect to rely on your family for care, discuss that with them now. That way, future caregivers can plan for the possibility. Also consider a backup arrangement in case your preferred caregiver can’t provide the level of care you need. 

    How can I get the most for my money?

    Long-term care insurance can be expensive, but there are ways to keep costs down:

    • Buy your plan between the ages of 60 and 65. Buy it as a couple, if possible.

    • Shop around. Roughly a dozen insurers now offer long-term care insurance. Premium rates vary, so look at plans from at least three companies.

    • If you’re eligible to write off medical expenses on your taxes (typically if they exceed 7.5% of your income), you can include a fraction of your long-term care insurance premiums in the write-off. The older you are, the larger the fraction. 

    The bottom line

    Long-term care insurance can protect your financial assets if you need ongoing medical services or help. The benefit amount that you need depends not only on your health and family history but also on how much you can afford to pay without insurance.

    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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