Can you get long-term care insurance if you smoke?

Smokers can and do buy long-term care insurance. Tobacco use is a rating factor, not an automatic decline — the bigger question is whether smoking has already caused another condition, not the habit by itself.

How smoking is underwritten

• Tobacco rates. Smokers pay higher premiums than non-smokers — often a meaningful percentage more for the same coverage — but smoking alone rarely prevents coverage outright.
• How much and how long. A long smoking history is read somewhat differently from occasional or recent use, since cumulative exposure relates to the odds of developing smoking-related disease.
• The real barriers. Smoking that has already led to COPD or heart disease is what makes coverage genuinely hard — the underlying disease, not the smoking history itself, drives the decision at that point.
• Nicotine counts broadly. Cigars, chewing tobacco, and vaping may all be treated as tobacco use depending on the carrier, even for people who never smoked cigarettes.
• How carriers verify it. Applications typically include a nicotine test (often a simple cotinine test via urine or saliva) as part of underwriting, so accuracy on the application matters.

Quitting helps — a lot

Most carriers offer non-smoker rates once you have been tobacco-free for a period — often around a year, though it varies by carrier, and some require longer. If you are planning to quit, doing so well before you apply can meaningfully lower your premium for the life of the policy, since the rate class you lock in typically does not change later just because you quit afterward.

A realistic picture

• A current smoker with no smoking-related disease still qualifies for coverage — just at tobacco rates rather than the lower non-smoker rates.
• A former smoker who quit over a year ago, with no lung or heart disease, typically qualifies for non-smoker rates, a real premium savings for the same coverage.
• A smoker who has developed COPD or heart disease faces underwriting based on that disease specifically — see those pages for how they are evaluated.

How to improve your odds and your rate

• Quit before you apply — even a year of being tobacco-free can move you into a meaningfully cheaper rate class.
• Be honest on the application. Nicotine testing is standard, and a misstatement about tobacco use can jeopardize a claim later.
• Address any related condition — if smoking has affected your lungs or heart, that condition is what really drives your options at this point.

General information only. Underwriting varies by carrier and changes often, and we do not publish carrier-specific approval thresholds. Nothing here is a guarantee of coverage or a quote — only a licensed carrier reviewing your medical history can tell you what you qualify for. This is educational and not insurance, legal, tax, or financial advice.