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Frequently Asked Questions

Applying for Coverage Under the Federal Program

Underwriting Questions

1. Do eligible applicants have to pass health requirements (underwriting) in order to get the insurance?
    
2. What is Underwriting?
    
3. What is Full Underwriting?
    
4. What is Abbreviated Underwriting?
    
5. Who can apply using the abbreviated underwriting application?
    
6. Who must use the full underwriting application to apply?
    
7. Why does the Federal Program require underwriting?
    

1. Do eligible individuals have to pass health requirements (underwriting) in order to get the insurance?

Yes. There are two levels of underwriting - full underwriting and abbreviated underwriting.

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2. What is Underwriting?

Underwriting is the process of reviewing medical and health-related information furnished in an insurance application process to determine if the applicant presents an acceptable level of risk and is insurable.

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3. What is Full Underwriting?

Everyone eligible to apply for coverage under the Program who does not qualify for abbreviated underwriting is subject to full underwriting. This means that they must answer more health-related questions. It may also include a review of medical records and possibly an interview with a nurse. This is the same level of underwriting that those who purchase individual policies in the private market typically undergo.

Get the Full Underwriting Application here.

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4. What is Abbreviated Underwriting?

Abbreviated underwriting has fewer health-related questions than full underwriting. Employees who are eligible for abbreviated underwriting and apply for the 3 year or 5 year benefit period answer seven questions about their health. Spouses of employees who are eligible for abbreviated underwriting answer nine questions, and may need to authorize access to their medical records. They may also have an interview with a nurse. Both employees and spouses will have to answer an additional six questions.

Get the Abbreviated Underwriting Application here.

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5. Who can apply using the abbreviated underwriting application?

The following groups can apply using the abbreviated underwriting application within 60 days of becoming eligible:

• New and newly eligible employees (including Uniformed Services).
• Spouses of persons in the above group, and
• Newly married spouses of employees.

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6. Who must use the full underwriting application to apply?

Anyone who does not qualify to use the abbreviated underwriting application. This includes:

• New and newly eligible employees who are NOT applying within 60 days of their hire or eligibility date,
• Spouses of employees who are NOT applying within 60 days of marriage,
• Annuitants, including retired members of the uniformed services
• Qualified relatives.

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7. Why does the Federal Program require underwriting?

We require medical underwriting for applicants because, in order for FLTCIP to be successful in the long run, the premiums charged for insurance coverage must be competitive with private sector policies. If we guaranteed standard insurance to all individuals who applied, we would have to add the expected costs of those in poor health to the premiums charged for coverage under the FLTCIP.

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

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