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Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-Risk Consumers

机译：长期护理保险中的医疗保险：市场条件限制高风险消费者的选择

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摘要

A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance.
机译：私人长期护理保险的一个关键特征是，医疗承保人会筛选出可能会导致近期身体或认知残疾的健康状况的潜在购买者。我们基于两家长期护理保险公司的数据，将通用承保标准应用于长期护理保险目标年龄范围（50-71岁）的全国代表性个人样本。筛查标准将目前在不改变医疗承保惯例的情况下就可以覆盖单个市场的美国人比例提高了上限。具体而言，我们的模拟显示，在目标年龄范围内，大约30％的财富达到长期护理保险适用性最低行业标准的人会在承保阶段拒绝此类保险的申请。在不考虑财务适合性的总体人群中，我们估计有40％的申请将被拒绝。预测的拒绝率大大高于实际市场中约20-25％的申请人的拒绝率。在评估长期护理融资改革及其提高私人保险费率以及减轻公共安全网计划的财务压力的潜力时，决策者需要考虑承保在长期护理保险市场中的作用。

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