LTC underwriting is the risk evaluation process carriers use to decide whether to issue long term care insurance or LTC riders and on what terms. Underwriters review age, medical history, medications, cognitive status, functional abilities, build, family history, and sometimes financial suitability. Because long term care claims are often lengthy and expensive, underwriting tends to be stricter than for many life insurance products, and borderline conditions such as mild cognitive impairment, mobility limitations, or multiple chronic illnesses can lead to declines or surcharges. Telephone or face to face interviews and cognitive screens are common for older applicants.

In practice, advisors experience LTC underwriting as one of the most challenging aspects of placing coverage, particularly for clients who wait until their late sixties or seventies to apply. They help clients prepare by gathering detailed health histories, clarifying medications and diagnoses, and setting expectations about possible outcomes. Advisors may prequalify cases with underwriters or wholesalers before submitting full applications, especially for clients with conditions such as diabetes, recent strokes, or use of mobility aids. When applications are declined for traditional LTC, producers may pivot to hybrid life or annuity based solutions with different underwriting criteria or benefit structures. By understanding LTC underwriting standards, common red flags, and carrier niches, advisors can guide clients toward more appropriate timing, products, and expectations, improving the chances of successfully securing meaningful care protection.