Potential Changes to Long Term Care Insurance Underwriting Standards

This memo is provided for informational purposes only and does not  constitute legal or professional advice.

A recent study entitled, "Genetic Testing for Alzheimer's and Long-Term Care Insurance," found that individuals who take a genetic test to find out if they have traits that lead to Alzheimer's are five times more likely to purchase long-term care insurance (LTCI).  This is causing LTCI providers to change underwriting standards that may impact individuals with HD.

The leading LTCI insurer, Genworth Financial, has announced changes to their underwriting plan design, including higher rates, and stricter underwriting standards before insuring risk.  Genworth Financial announced that it may in some cases require genetic testing of LTCI applicants with a family history of genetic disorders, like Huntington’s disease.  Genetic testing was also a topic at the 13th Annual Intercompany Annual Conference, a conference of long term care insurers which was held in March, 2013.  In a session entitled “Genetic Testing: Underwriting Risk or Fear”, HD was used in a case example. 

For LTCI purposes, the issues with HD are about whether genetic testing has been recommended by a physician.  In a case where testing has been recommended by a physician, then the insurance company will require the testing to be done before issuing/declining a policy.

Our understanding is, if a recommendation for testing is not part of the applicant’s medical history and there are no symptoms or diagnosis of HD in their medical history, then under the proposed standards the applicant’s premium would only be impacted by family history (assuming there are no other underwriting considerations).

Long term care insurers tend to follow each other’s underwriting standard so we expect others in the field would follow Genworth’s new genetic testing criteria.  Currently, only 10 states regulate the use of genetic information in LTCI underwriting.  While GINA legislation prohibits the use of genetic information for health insurance decisions, the prohibition does not apply to LTCI consideration.  Learn more about GINA at www.hdsa.org/gina.    

Individuals with a family history of HD may want to consider purchase of LTCI before LTCI genetic testing underwriting standards are implemented.  Given the progression of use of genetic testing and the gap in GINA for exclusion of genetic testing in LTCI underwriting, there may well come a time when testing may be required based on family history.

For more information about LTCI, talk to your HDSA Social Worker.  Find the social worker close to you at www.hdsa.org/sw or by calling the HDSA Helpline at 888-HDSA-506.

Find out the laws in your state by going to: http://www.ncsl.org/issues-research/health/genetic-nondiscrimination-laws-in-life-disability.aspx