Key Takeaways

• Underwriters focus on consistency, completeness, and clarity in LTC applications, so preparing clients ahead of time reduces surprises and delays.

• When you understand what underwriters are evaluating, you can structure applications that move through approvals smoothly and strengthen client trust.

Setting the Stage for Successful LTC Applications

As an independent licensed agent working with Medicare clients, you know long-term care (LTC) insurance conversations often carry high stakes. What many agents underestimate is how much underwriters value certain details that make or break the approval process. In 2025, underwriters have become stricter due to rising claim costs and demographic shifts, which means missing or vague information can derail an application quickly. Your job is not just to collect forms but to anticipate what underwriters want to see.

Why Underwriting Matters More Than Ever

The underwriting process is where the client’s application transforms from a hopeful request into an evaluated risk profile. Underwriters are tasked with ensuring the insurer is not exposed to undue risk while still providing clients with fair coverage. This balance means every detail on an application is scrutinized. If information is missing, inconsistent, or unclear, the process slows down or ends in a decline. In the LTC market, delays can easily stretch beyond 30 to 60 days, frustrating both you and your client.

Health History Transparency

The first priority for underwriters is a clear and accurate health history. Clients sometimes underreport or forget conditions, but underwriters verify these details through medical records, prescription histories, and attending physician statements. Any gaps between the application and what underwriters uncover raise red flags.

• Encourage clients to list every doctor they have seen in the past 5 years.

• Ask clients to provide a full medication list, even for over-the-counter or occasional prescriptions.

• Confirm accurate details on surgeries, hospitalizations, or ongoing treatments.

By coaching clients upfront, you reduce the chance of discrepancies that could otherwise cause lengthy back-and-forth communication.

Lifestyle and Daily Functioning

LTC coverage is fundamentally about the risk of needing assistance with activities of daily living (ADLs). Underwriters want a realistic picture of a client’s ability to function independently.

• Gather details on mobility, including any assistive devices such as canes or walkers.

• Note whether clients have a history of falls in the last 12 months.

• Clarify cognitive status, especially if there have been concerns of forgetfulness or mild cognitive impairment.

Even when a client feels healthy, these details matter because they speak to future claim potential. Framing these questions carefully helps you gain the trust of clients while still capturing the information underwriters require.

Financial Suitability

Underwriters are also concerned with whether the applicant can realistically afford and maintain the policy. While you don’t disclose exact income and assets in the same way as financial underwriting for other products, the client’s financial stability still matters.

• Document consistent income sources such as retirement benefits, pensions, or Social Security.

• Note the client’s history of maintaining other insurance policies without lapses.

• Provide reassurance that the premium fits comfortably within the client’s monthly budget.

This shows underwriters that the client is not at high risk of lapsing in the near future, which would undermine the long-term sustainability of the coverage.

Accuracy of Application Details

Incomplete or inconsistent answers are one of the top frustrations for underwriters. Something as small as mismatched dates for a surgery can trigger time-consuming verifications.

• Review every section of the application with the client before submission.

• Double-check that signatures, dates, and initials are provided everywhere required.

• Ensure all “yes” answers on health questions include sufficient explanatory details.

The cleaner the application, the faster underwriters can move it through their review process.

The Role of Attending Physician Statements

In many cases, underwriters will request an Attending Physician Statement (APS). These reports can take weeks to obtain, but they are often the deciding factor in approvals. As an agent, you cannot speed up the doctor’s office, but you can:

• Inform clients that APS requests are common and prepare them for the timeline.

• Encourage clients to let their physician’s office know to expect a request.

• Gather as much supporting documentation as possible upfront to minimize reliance on APS.

Setting the right expectations prevents client frustration when the process extends longer than they anticipate.

Prescription Checks and Consistency

Underwriters regularly run prescription database checks. Any undisclosed medication, even something prescribed years ago but still active in the record, can raise concerns.

• Ask clients if they have ever been prescribed medications they no longer take.

• Clarify the reason for each medication, especially if it could be linked to serious conditions.

• Document any changes in prescriptions to demonstrate stability or improvement.

These steps show underwriters that you are not trying to hide anything and that your client is forthcoming.

The Importance of Timeframes

Underwriters evaluate applications within clear timelines, often using 5-year lookbacks for medical visits and 10-year windows for major procedures or hospitalizations. As an agent, aligning your fact-gathering process with these timeframes makes your application more reliable.

• Focus on the last 5 years for standard health events.

• Highlight any major surgeries or treatments within the past 10 years.

• Provide clarity on resolved conditions, especially those more than 5 years old.

Being specific about dates avoids ambiguity and demonstrates a level of preparation underwriters appreciate.

Preparing Clients for Interviews

Many LTC applications involve a telephone or video interview with a third-party nurse or evaluator. Underwriters expect these interviews to confirm what is written in the application.

• Advise clients to have their medication bottles, physician contact information, and recent test results on hand.

• Remind them to answer honestly and avoid minimizing conditions.

• Suggest they schedule the interview when they are well-rested and alert.

When clients know what to expect, they provide clearer answers, which makes the underwriter’s job easier.

Communication and Responsiveness

Once an application is submitted, underwriters may reach back with questions. Delays in responding to these can stretch an approval timeline indefinitely.

• Provide your best contact information on the application so underwriters can reach you.

• Commit to responding to underwriter requests within 24 to 48 hours.

• Keep clients updated on what has been requested and why.

This level of communication reassures underwriters that you are organized and committed to supporting the process.

Building Trust with Underwriters

Over time, underwriters begin to recognize agents who consistently submit thorough and clean applications. Your reputation plays a role in how smoothly future applications move.

• Submit applications that are fully complete on first attempt.

• Provide proactive explanations for anything unusual in the application.

• Build relationships with underwriter teams through professionalism and reliability.

By positioning yourself as a trusted partner rather than just a form-filler, you increase the likelihood of positive outcomes for your clients.

Where Professional Agents Win

In 2025, the LTC underwriting landscape is more detail-oriented than ever. Agents who thrive are those who anticipate underwriters’ expectations and build strong habits of preparation. Clients benefit when their applications are approved faster, and agents benefit by avoiding difficult conversations about unexpected declines. Underwriters are not trying to make your job harder—they are trying to ensure sustainability in a challenging insurance market. When you work with their priorities instead of against them, everyone wins.

Helping You Stay Ahead

By now, it should be clear that underwriters are looking for transparency, accuracy, and consistency above all else. Your role is to translate that into a process clients can follow easily. When you guide them through gathering records, clarifying details, and preparing for interviews, you eliminate surprises that would otherwise jeopardize the approval.

At BedrockMD, we understand these challenges firsthand. That is why we provide resources, training, and tools that keep you ahead of underwriting requirements. By partnering with us, you gain insights into what underwriters are prioritizing in 2025 and beyond. Sign up today to see how we can help you submit stronger applications and secure better outcomes for your clients.