At Easy Care Decision, we use this quick pre-screen to understand your unique situation and see which long-term care insurance options you may qualify for. Once you submit your answers, a licensed advisor will follow up with your results — and help you take the next best step, if you're ready.

START HERE

Important Note About Eligibility
Some health conditions and medications may prevent you from qualifying for long-term care insurance. Please review the list below to see if any apply to your situation.

If you’re unsure or have questions, don’t hesitate to reach out — we’re here to help.

Uninsurable Medications

Antabuse®, Aricept®, Artane®, Avonex®, Azilect, Betaseron®, Campral®, Cogentin®, Cognex®, Comtan®, Copaxone®, Depade, Donepezil, Eldepryl®, Exelon®, Fentanyl, Galantamine, Hydergine®, Interferon®, Larodopa®/L-Dopa, Lucemyra, Memantine, Methadone, Mirapex®, Namenda®, Namzaric, Parlodel®, Permax®, Razadyne®, Reminyl®, ReVia®, Rivastigmine®, Sinemet®, Suboxone®,
Symmetrelº, Vivitrol®

Some of these medications may be considered if taking for a different reason than normally prescribed.

Uninsurable Conditions

Activity of daily living deficits (need help with any of the ADL’s)

Alcoholism (active)

Alzheimer’s/Dementia

Amyotrophic Lateral Sclerosis (ALS)

Balance disorder/Gait impairment

Cerebral palsy

Cirrhosis

Depression (severe or hospitalized in the last 5 years) 

Down syndrome

Drug addiction/illicit drug use (within last ten years)

HIV positive

Huntington’s disease

Memory loss

Mental retardation

Multiple myeloma

Multiple sclerosis (MS)

Muscular dystrophy

Organ transplant (except kidney)

Organic brain syndrome

Osteoporosis with compression fracture

Paralysis (paraplegia/quadriplegia)

Parkinson’s disease

Pregnancy (current)

Stroke (multiple or residual effects)

Surgery pending (will review after)

Ventricular tachycardia

Build Chart

*Carriers' build charts vary; this is one example of an aggressive build chart.

About You

*This is a confidential form used only to verify which long-term care insurance options you might be eligible for. This is not an application for insurance. 

Your Health

Your Spouse

Final Questions

Office:

1353 N Courtenay Pkwy Suite N

Merritt Island, FL 32953

Call

321-877-0055

@easycaredecision

@easycaredecision

@easycaredecision