Jeffrey Karelis, an advisor who is a partner in KSP Financial Consultants in Waltham, Massachusets, favors buying LTC insurance when clients are in their late forties. He isn’t always successful in convincing them, although “some have been my friends,” he says. He cites one client in particular, whom he’d begun urging four years ago to buy coverage. Now the client is uninsurable, thanks to “a bleed–a carotid artery tear–and I used to think the only people who got strokes were people in their seventies and eighties. Now it’s forties and fifties,” says Karelis. Insurance companies, he says, “won’t touch” a stroke victim, fearing such a policyholder will end up “nonambulatory for 30 years.”

Another client of Karelis without coverage has had Parkinson’s disease for nine years, and “around-the-clock care for eight,” costing over $185,000 annually just for home care. “If you do the math, $21 an hour, 24 hours a day, 365 days–plus incidentals–he’s spent $1.4 million.”

Not all the news is bad, though. “I have on more than one occasion put LTC in place for someone who very soon thereafter did need it, but wouldn’t have been able to satisfy the medical underwriting,” he says. One client discovered he had cancer a month after the policy was in place. Had he waited, coverage would be out of the question.