Long-term care insurance not only costs a lot of money, but the approval process to get it can also feel like an Olympic steeplechase, especially when there are pre-existing conditions or other situations.

After all, insurance companies are running a business, so they apply strict standards to long-term care insurance applications to screen out people who present too high a risk. As a result, people get a thumbs down all the time. According to industry statistics, as many as one-third of all people in their sixties when applying for long-term care insurance say NO!

If that happens to you, don’t panic. There’s still hope. Here are the questions to ask your agent:

• Does the company have an appeal process?

Most of them do. If so, take a copy of the company’s denial letter to your doctor. The letter will specify why you were rejected (or hit with a much higher premium than you expected).

The doctor’s answer to the reasons why the company rejects him is fundamental, and it is shrouded in mystery. Unless he’s in the medical field, he won’t understand a tenth of what the letter says. So he just has to have faith that the doctor has made a bulletproof case for the company to accept him.

Just remember, insurance companies can put out some really big boners. In one situation that I am aware of, the company said that part of the denial was based on some medical conditions that the doctor had never seen in the patient. Part of the doctor’s gruff response: “I certainly appreciate you bringing these medical issues to my attention. In over 20 years of being this patient’s physician, I have never come across such conditions in this patient.”

Despite the cheeky tone of the letter, the doctor made such a convincing case that the insurance company issued a policy after all.

However, keep in mind that appeals are not successful very often. But it happens. I myself know of two situations where a doctor’s letter won the day.

Keep in mind, too, that doctors are very busy. You may need to give the doctor a few nudges before the letter materializes.

• Do you have another policy or company whose coverage is not as good but for which I would probably qualify?

Agents want to get a commission for working with you, so they’ll usually have a couple of alternative companies or policies to show you if your first option doesn’t work out. And if you’re working with an agent who has experience with long-term care policies (fingers crossed you chose such an agent in the first place) they may even be able to get you a policy with a leading company at standard rates.

In short, being turned down by an insurance company is not the end of the road. It may simply mean that you will have to take a detour or two to get where you want to go.