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
