One feature to remember about the Federal Long Term Care Insurance Program is that one must apply for it, rather than enroll in it. That is because the program has underwriting requirements, which generally don’t apply in the other government-sponsored insurance programs for federal workers—the exception is that in the FEGLI life insurance program when seeking to increase coverage even though no qualifying life event (such as marriage) has occurred.
Underwriting is the process of reviewing medical and health-related information furnished in an insurance application process to determine if the applicant presents what the insurance industry considers an acceptable level of risk.
In the FLTCIP, newly hired employees, their spouses and newly acquired spouses of current employees, and similarly situated domestic partners, may apply for the program using the “abbreviated” underwriting application within 60 days of becoming eligible. After that time, they can still apply, but have to use the “full” underwriting application form that asks more questions about the state of their health. Full underwriting always applies to retirees and their eligible family members, unless that person is eligible for abbreviated underwriting on his or her own accord.
In abbreviated underwriting, the application has several health-related questions designed to determine who may be immediately eligible for benefits, or eligible for benefits within a short time. The questions ask whether the applicants: currently are receiving long-term care type services; are being (or have been) treated for certain conditions, including Alzheimer’s; use certain types of medical devices; or have been diagnosed with mental or nervous disorders that have required hospitalization. Spouses eligible for abbreviated underwriting also must answer whether they require help with certain activities or use crutches or a multi-prong cane.
Full underwriting asks numerous health-related questions. It may also include a review of medical records and/or a personal interview. In addition to the questions applying in abbreviated underwriting, full underwriting asks additional medical questions as well as lifestyle-type questions, including queries on exercise habits and use of alcohol and tobacco.
If your application is approved, it doesn’t matter if you have a pre-existing condition. You will be offered the standard insurance product. Individuals who do not pass underwriting will be offered non-standard insurance or services.