About Senior Supplement/Cognitive Testing
More carriers are now requiring a Senior Supplement test be done by the medical examiner on cases where the proposed insured is age 70 and up for both life insurance and long-term care. It’s designed to ask the client simple things about their lifestyle, capabilities, mobility, and activities. This supplement is designed to test not only their ability to do the normal requirements of daily living, but more importantly, it’s a test of their cognitive abilities.
What Does Cognitive Testing Assess?
Cognitive testing assesses problems with attention, memory, learning, decision making, and problem solving. Intellectual decline is prevalent at older ages, but is not normal, nor is it part of the normal aging process.
If there is definitely cognitive impairment, there is also an increased mortality risk. Mild Cognitive Impairment (MCI) is often an indication of preclinical dementia, and is not age-associated memory impairment. MCI progresses to dementia at a rate of about 12-15% per year (from studies provided by Prudential). Testing can detect MCI before it is clinically apparent.
What Does the Test Consist Of?
The cognitive testing often includes tests specifically designed to measure the proposed insured's abilities with things such as a clock draw. In this test, the examiner will ask them to draw a clock face, then show the time of 10 minutes past 11. This test is designed to see how well they can follow directions, and evaluate brain function, planning, and decision making.
Another test, and the one that raises the most concern, is the delayed word recall. In this test, the client is given a list of 10 words and asked to use each in a sentence. Then, 5-10 minutes later, they’re asked to repeat as many as they can recall. Typically, they need to reply with at least 6 words or more to pass.
Preparation for Senior Supplement/Cognitive Testing
To give your senior clients (age 70+) the best chance of success with their Senior Supplement, here are the primary issues to discuss:
- Make sure they’re prepared and understand that someone will be testing them on their cognitive abilities.
- Make sure they’re aware of the importance of the test and the impact it can have on their ability to get their needed coverage.
- Have them be prepared to focus without distractions — no television being played, or work/office distractions present.
- If it’s not a good time, or there are distractions, ask to have the appointment rescheduled.
- If they happen to fail the test, have them prepared to go to their personal doctor for further testing and evaluation. Most carriers will allow this after a failed test.
The best thing you can do for your clients is to prepare them for this test. Let them know that they're going to be tested as part of the insurance exam. With some carriers, this takes place with a follow-up phone call.
We’ve heard from a lot agents and clients after their failed cognitive test that the client wasn't aware this was going to be part of their exam. They also didn't know how important it was for them to answer these seemingly silly questions.
At that point, it’s too late. We then have to ask the carrier for an exception to allow the insured to visit their own doctor to do further testing and hopefully rule out cognitive impairment.
As always, we're here to help you answer questions, and provide the best underwriting services possible to help you place cases.
Click here to contact our underwriter, Mike Woods, with specific underwriting questions about the Senior Supplement/cognitive testing.