Underdiagnosis Impacts Long Term Care Insurance Eligibility

This condition affects many people and, yet they may have never been diagnosed; SLEEP APNEA.

For those of us in the long-term care insurance industry we need to be more mindful of sleep apnea and its effect on eligibility for people applying for long term care insurance protection.

Sleep apnea occurs, during sleep, when lack of air entering the lungs is caused by a narrowing of breathing passages which results in less oxygen reaching vital organs. The body then tries to compensate for the perceived obstruction, which in many cases, results in snoring. These pauses can last from a few seconds to minutes. The pauses can be more than 30 times per hour, and in one insurance company’s Underwriting Guide, could be considered severe and uninsurable.

Sleep Apnea can be diagnosed by a physician based on answers to a variety of questions and, or, a physical exam that indicates an enlarged uvula or a soft palate. The doctor may also prescribe a sleep study where a specialist conducts a Polysomnogram, a sleeping exam that is conducted in a controlled setting using electrodes and monitoring to determine the exact numbers of time sleep is interrupted and the body’s response to those interruptions.

The number of times breathing stops during sleep (apnea) is measured and can be mild, moderate or severe. Anything more than 5 cessations per hour is considered abnormal and the reduced airflow (hypopnea) to the lungs determines the AHI, or Apnea-Hypopnea Index. That AHI is now listed in Underwriting Guides to assist in determining whether the afflicted individual is insurable.

Once someone applying for long term care insurance says they have been diagnosed with Sleep Apnea we need to ask appropriate questions: date of diagnosis, how were they diagnosed, what is their AHI, what is their proscribed treatment and are they compliant with doctor’s treatment recommendations.

Always work with a Specialist when applying for long term care insurance. Specialists are mindful during our health interview and ask all the pertinent questions because Sleep Apnea may prevent eligibility for long term care insurance. Or, which insurance company could be more amenable to a certain set of health issues. All our SFA agents are specialists and can best help us with the issue of Sleep Apnea.

Diana Hayn



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