Behind the Curtain: How Insurers Decide Who Gets Coverage
In one free 30‑minute Family Care Plan Review, a licensed long-term care specialist explains what insurers look at, which types of coverage are more flexible about health history, and compares traditional, hybrid, and annuity-based options side by side for you.
And you’ll see why about 1 in 4 traditional long-term care applications was declined or deferred in 2024,1 and why the insurer you apply to can change the answer.
Claim my free 30-minute reviewFree. No obligation. A licensed professional responds within 1 business day.
- 45+ years in long-term care insurance
- CLTC® & LTCP designations
- Genworth BGA partner, 2000–2016
- Florida DFS approved CE instructor
American Heart Month is a reminder that health changes your options
Heart disease is the leading cause of death in the United States.2 Nearly half of adults have high blood pressure, and only about 1 in 4 of them have it under control.3
Long-term care insurance is medically underwritten. Before it offers coverage, the insurer reviews your health history and medications, and sometimes holds a phone interview, then decides whether to offer coverage and at what price.
Most people never see how that decision is made, until a letter arrives.
Understanding underwriting before you apply is the best way to avoid a decline you didn’t see coming.
What the numbers say about underwriting
Underwriting outcomes vary more than most people expect:
Four underwriting mistakes that cost families coverage
- Applying to just one insurer. Each insurer sets its own rules. Decline and deferral rates ranged from about 15% to 34% depending on the insurer.1
- Waiting for a “better” health year. Health rarely improves with age, and every birthday moves you into an older rate band.
- Assuming one condition rules you out. Many well-managed conditions are considered case by case, and some hybrid and annuity-based options use simplified underwriting.
- Leaving things off the application. Incomplete or inaccurate answers can lead to a denied claim later. A complete, accurate application protects you.
A specialist who knows how different insurers underwrite can tell you, before you apply, where you’re most likely to be accepted. See how underwriting works.
The Three-Path Comparison: every type of coverage, side by side, in one conversation
Instead of one product from one company, your Family Care Plan Review looks at all three ways to pay for care. We compare them across insurers for your age, health, and budget, then show you the trade-offs in plain English.
Path 1: Traditional long-term care insurance
Medically underwritten coverage that pays a daily or monthly benefit once you need help with daily activities.
Often the most coverage for the premium for healthy applicants 45 to 65.
How it’s underwritten →Path 2: Hybrid (asset-based) coverage
Life insurance with a long-term care benefit. If you never need care, the death benefit still goes to your family.
Popular with couples who want their money to work either way.
How it’s underwritten →Path 3: Annuity care
A deferred annuity paired with long-term care benefits that can be larger than the deposit, often funded from existing savings.
An option to explore when health makes other coverage harder to get.
How it’s underwritten →More than four decades of helping families plan for care
George A. Mellendorf founded Central States Insurance Services in Ft. Myers in 1981. It grew into a national long-term care insurance brokerage, and from 2000 to 2016 it served as a Brokerage General Agent for Genworth, at the time one of the largest long-term care insurers in the country.
- CLTC (Certified in Long-Term Care) and LTCP (Long-Term Care Professional) designations
- Approved continuing-education instructor on the Florida Department of Financial Services registry (Instructor ID #737925), teaching other licensed agents
- Florida licensed insurance agent, License # A175981. Verify the license
“When I first started in the ‘nursing home insurance’ business in 1981, the average age was 74. Today we are down to the mid-50s and early 60s.”
George A. Mellendorf · Read his story
Thirty minutes from now, you could know exactly where you stand
- Peace of mind for your children. A plan that keeps them in the role of family, not full-time caregiver.
- A clear answer to “what would it cost us?” Real numbers for your age and health, not a generic rate sheet.
- Confidence you didn’t overpay. In 2026, the highest price for virtually identical coverage was 56% above the lowest.4 Comparing is how you avoid that gap.
- Your savings and home protected from being drained by years of care costs.
- Choices about where you get care, at home, in assisted living, or in a nursing home.
- A decision made calmly, on your schedule, instead of in a hospital hallway after a diagnosis.
Your free Family Care Plan Review
A 30-minute conversation with a licensed long-term care specialist. Even if you never buy a policy, you’ll leave knowing your options, what they cost, and what to ask.
- The review
Your Three-Path Comparison
Traditional, hybrid, and annuity-based coverage compared across insurers for your age, health, and budget, with the trade-offs explained in plain English.
Bonus 1Long-Term Care Insurance Buyer’s Guide
The three coverage types, the riders worth paying for, how underwriting sets your rate, and how to compare quotes side by side.
Bonus 2LTC Policy Checklist & Financial Workbook
Fill it in before your review so you know your budget, your assets, and the questions to ask.
Bonus 3Long-Term Care Tax Guide
How long-term care premiums may be tax-deductible, so you can factor that into the real cost.
No cost and no obligation to buy anything.
Your health today sets your options tomorrow
Long-term care insurance is medically underwritten. Insurers look at your age and health on the day you apply.
That means the best time to compare is while you’re healthy. A new diagnosis, a fall, or a change in medications can raise the price or rule out some options entirely, and every birthday moves you into an older rate band.
American Heart Month is a good reason to find out where you stand while you have the most choices. The review takes 30 minutes; waiting can cost far more.
Free to compare. Free to say no. Protected if you say yes.
The review costs nothing, and you’re never under any obligation to buy.
If you do choose a policy, Florida law gives individual long-term care insurance policyholders 30 days after delivery to review it and return it for a full premium refund, for any reason.6
Four simple steps, and you’re in control at every one
- Send the short formName, contact details, and a few quick questions. About two minutes.
- We call to scheduleA licensed specialist contacts you within 1 business day to pick a time that works.
- Your 30-minute reviewBy phone. We go over your goals, health, and budget, and compare all three paths.
- You decideTake the side-by-side comparison home, talk it over with family, and choose, or don’t.
Prefer to talk now? Call (239) 218-7309.
Before you request your review
Is the review really free? What’s the catch?
Yes, it’s free and there’s no obligation. You’ll get a side-by-side comparison you can keep, whether or not you buy anything.
Will I be pressured to buy?
No. The goal of the review is for you to understand your options. Many people take the comparison home and talk it over with their family first.
What does the insurer look at?
Typically your health history, current medications, recent treatment, and whether you need help with daily activities. Some insurers also hold a phone interview that can include a short memory screening. Your review explains what each insurer is likely to ask.
I already have a chronic condition. Can I still get coverage?
It depends on the condition and how well it’s managed. Each insurer underwrites differently, which is exactly why comparing matters. Some hybrid and annuity-based options use simplified underwriting. Final eligibility is always decided by the insurer.
What happens if I’m declined?
A decline from one insurer doesn’t always mean a decline from all. We look at other insurers and other paths, since hybrid and annuity-based options may use different underwriting. Final eligibility is always decided by the insurer.
What does long-term care insurance cost?
It depends on your age, health, and the benefits you choose. As one benchmark, in 2026 a couple both age 55 paid an average of about $5,010 a year combined for $165,000 in initial benefits each.4 Your review shows real numbers for you.
Is Funding LTC Marketplace an insurance company?
No. We’re a marketplace and advisory service operated by Central States Insurance Services, Inc. We compare coverage from insurers; the insurer issues the policy and makes the underwriting decision.
Can my adult children join the call?
Yes, and many families find that helpful. Just let us know when we schedule.
P.S.
P.S. Here’s the short version. In one free 30-minute Family Care Plan Review, a licensed specialist compares traditional, hybrid, and annuity-based coverage side by side for you, and you get three free planning guides.
If you do nothing, your health still decides. It just decides later, when there may be fewer options. Find out where you stand while you’re in a position to choose.
Sources
- Milliman 2025 Long-Term Care Insurance Survey (Broker World)
- CDC: Heart Disease Facts
- CDC: American Heart Month
- AALTCI 2026 Long-Term Care Insurance Price Index
- CareScout 2025 Cost of Care Survey
- Florida Department of Financial Services: Long-Term Care Overview (30-day free look)
Funding LTC Marketplace is operated by Central States Insurance Services, Inc., Ft. Myers, FL. George A. Mellendorf, CLTC, Florida licensed insurance agent, License # A175981, NPN # 538220. Verify at licenseesearch.fldfs.com/Licensee/211790. This is not an offer of insurance. Coverage, rates, and eligibility are determined by the issuing carrier through underwriting. Not affiliated with or endorsed by Medicare or any government agency. Educational content only, not medical, legal, tax, or financial advice.