Unit 21: Long-Term Care

inflation protection

An insurance policy benefit that increases benefits to keep up with anticipated cost increases for long-term care services is said to have

elimination period

An insured must receive care for a stated number of days before a long term care policy can pay benefits. This time deductible is known as the

guaranteed insurability

An optional benefit that allows an insured to buy additional coverage at certain times using their attained age is

housing, meals, and help with personal care

Assisted living facilities provide

Long-term care insurance

Becky wants to make sure that she has insurance to protect herself if she eventually needs long-term custodial or nursing home care. What type of policy will cover these types of care?

dollars per day

Benefit amounts in a long-term care policy are usually expressed as

whether an individual can perform the activities of daily living

In regards to underwriting considerations of long-term care policies, the key decision is based on

assisted living care

Individuals that need assistance from time to time but can live more independently than people who need custodial care may need

inflation protection

Javier purchased a long-term care insurance policy with an optional benefit that provides a yearly increase in benefits. His policy offers

Custodial care

Kathleen needs help with eating, bathing, and dressing. Which level of long-term care does Kathleen need?

3 Levels - Skilled nursing care - Intermediate care - Custodial care

Levels of facility based long-term care:

day

Long-term benefit amounts are usually expressed as dollars per

cognitive or mental impairment

What is a common benefit trigger for a long-term care policy?

A condition for which advice or treatment was received within 6 months before the effective date of coverage

What is the definition of pre-existing condition in a long-term care policy?

Another individual also receives the premium notice due

What protects an insured against unintentional lapse?

Guarantee of insurability

What provision gives a long-term care policyowner the option to purchase additional insurance amounts within specified parameters regardless of insurability?

Long-term care

What type of care is described as a broad range of medical, personal, and environmental services designed to assist individuals who have lost their ability to remain completely independent in the community?

the suitability of the purchase

When marketing long-term care insurance, the insurer or agent must consider

30 days

How long is the free-look period in a long-term care insurance policy?

its benefits will qualify for tax-exempt treatment

If a long-term care policy is considered tax qualified,

custodial care

The type of care that provides assistance with the activities of daily living performed by unskilled helpers is known as

an elimination period

A deductible that is measured in time rather than deductibles is called

12 months; 2 to 5 years

A long-term care policy benefit period is a minimum of ___ months but will usually last __ to __ years

nonpayment of premiums

A long-term care policy can be terminated because of the insured's

- Eating - Dressing - Toileting - Continence - Bathing - Transferring

Activities of Daily Living (ADLS) include:

Home health care

Carl is 95 years old and often needs skilled medical and therapy services in his home. What type of long-term care does he need?

be diagnosed as chronically ill

For a long-term care insurance policy to begin paying benefits, the insured must

3 months

For long-term policies to be considered qualified , a health professional must certify that a chronic illness will last for at least a minimum of

- home health care - adult day care - respite care, and - assisted living facilities

Long-term care insurance types of care include

30 days

Marketing standards for long-term care policies require a free look period of

intermediate care

Medical or rehabilitative care performed on an intermittent basis is known as

- policy replacement, - conversion, - marketing standards, - prohibitions on limits and exclusions, - policy renewability, and - others

NAIC's long-term care insurance model regulations which address:

Eating is considered a measurement of the most impaired person

One of the requirements of a qualified long-term care policy is the inability of an insured to perform a number of the activities of daily living by themselves. Which ADL is considered a measurement of the most impaired person?

- Guaranteed insurability - Nonforfeiture - Inflation protection

Optional benefits in a long-term care insurance policy include:

HIPAA

Qualified long-term care policies must meet the specific requirements of

Guaranteed insurability

Roxanne wants to buy additional coverage in the future using her attained age and without having to provide evidence of insurability. What optional benefits should Roxanne add to her long-term policy?

skilled care must be available 24 hours a day, while intermediate care is daily, but not 24-hr care.

Skilled nursing care differs from intermediate care by:

around the clock

Skilled nursing long-term care is provided

True

TRUE or FALSE: As a result of the 1996 Health Insurance Portability and Accountability Act (HIPAA), all long term care policies sold today must be guaranteed renewable

FALSE - they are not taxable income

TRUE or FALSE: Employer-paid premiums are taxable income to the employees.

True

TRUE or FALSE: Employers who pay long-term care insurance premiums on behalf of employees may deduct them as a business expense.

False

TRUE or FALSE: The longer the elimination period, the higher the premium

time deductible

The elimination period may be thought as a

12 months

The minimum benefit period for a long-term care insurance policy is