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Frequently Asked Questions |
Applying for Coverage
Abbreviated and Full 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 to be considered insurable under the insurance program.
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2. Do eligible individuals have to pass underwriting in order to be approved for Federal Long Term Care Insurance (FLTCIP) coverage?
Yes, individuals are required to undergo either full or abbreviated underwriting, based on their eligibility group.
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3. Why does the FLTCIP require underwriting?
The Long-Term Care Security Act, which established the FLTCIP, recognized that underwriting would be necessary. The law states, "Nothing in this chapter shall be considered to require that long-term care insurance coverage be guaranteed to an eligible individual."
Underwriting is necessary to ensure the long term health of the program. The premiums charged for insurance coverage must be competitive with private sector policies. If we guaranteed standard coverage 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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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 2, 3, or 5 year benefit period answer 7 questions about their health. Spouses of employees who are eligible for abbreviated underwriting answer 9 questions and need to authorize access to their medical records. They may also have an interview with a nurse.
Employees and spouses who are eligible for abbreviated underwriting and apply for the unlimited benefit period answer fewer questions than full underwriting and need to authorize access to their medical records. They may also have an interview with a nurse.
Get the abbreviated underwriting application here.
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5. Who can apply using the abbreviated underwriting application?
The following new applicants can apply within 60 days of becoming eligible using the abbreviated underwriting application:
If you would like to apply and have questions about which application to use, visit the Apply section of our website.
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6. How do you define new employee and newly eligible employee?
A new employee is someone who was hired or began his or her position within the past 60 days. Those with prior Federal service must have had a break in service of at least 180 days. New District of Columbia employees (except for D.C. Courts employees) are not eligible to apply for this insurance.
A newly eligible employee is someone starting a job in a FLTCIP-eligible group. For example, someone who was an intermittent employee and then moved to a full-time permanent position without a break in service would be a newly eligible employee. Another example is a member of the Individual Ready Reserve who moves into the Selected Reserve.
For a more detailed listing of new and newly eligible employees, please visit the Which Application to Use section of our website.
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7. I am a new employee but I am also the spouse of an eligible employee. Do I have to answer questions 8 and 9 on the abbreviated underwriting application?
No.
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Everyone eligible to apply for coverage under the FLTCIP 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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9. Who must use the full underwriting application to apply?
The following new applicants must apply using the full underwriting application:
If you would like to apply and have questions about which application to use, visit the Apply section of our website.
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| Call: 1-800-LTC-FEDS (1-800-582-3337) (TTY: 1-800-843-3557) |
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