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Applications Icon FLTCIP 2.0 Applications for the Federal Long Term Care Insurance Program

Download an Application

Please read the materials in the Information Kit before you apply for coverage under the FLTCIP. If you have already read these materials, you will need to determine which application you can use . Then you can download that application below.
 

  Adobe PDF version Full Underwriting Application
Adobe PDF version

 Supplemental Answers for Full Underwriting Application
Adobe PDF version Abbreviated Underwriting Application
Adobe PDF version

 Supplemental Answers for Abbreviated Underwriting Application


In order to download the applications above, you need the free Adobe Acrobat Reader.

1-800-LTC-FEDS (1-800-582-3337)  (TTY: 1-800-843-3557)

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The Federal Long Term Care Insurance Program is
sponsored by the U.S. Office of Personnel Management,
offered by John Hancock Life & Health Insurance Company, Boston, MA 02117,
and administered by Long Term Care Partners, LLC