Little is known about the accuracy of medical underwriting for long-term care insurance. The lack of data on claims experience continues to be an obstacle in testing the ability of medical underwriting to identify above average financial risks. This study used actual claims data to simulate medical underwriting and to examine the risk, duration, and timing of nursing home use for people with conditions that are uninsurable. The results show that at least one older person in seven who is rejected for long-term care insurance due to underwriting may not represent greater financial risk to insurers than do those who are accepted.