Long-term care insurance not only costs a lot of money, but the approval process to get it can also feel like an Olympic obstacle course, 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 weed out people who pose too high a risk. As a result, people get a thumbs down all the time. According to industry statistics, up to a third of all people in their sixties when they apply for long-term care insurance are told 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 appeals 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 response to the company’s reasons for rejecting him is critical, and 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, the insurance companies can put out some really big boners. In one situation I know of, the company said that part of the rejection was based on some medical conditions that the doctor had never seen in the patient. Part of the doctor’s harsh response: “I certainly appreciate your bringing these medical issues to my attention. In more than 20 years of being this patient’s physician, I have never encountered such conditions in this patient.”

Despite the cheeky tone of the letter, the doctor made such a compelling 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 pushes 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 make a commission for working with you, so they will 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’ll have to take a detour or two to get where you want to go.