Chapter H5: Private Insurance Plans for Seniors

Qualified Long-Term Care policies may take into consideration an applicant's pre-existing conditions for a maximum of not more than __ month(s) prior to the effective date of coverage.?

6. ( If a pre-existing condition waiting period applies, the policy must not exclude coverage for any pre-existing conditions that occurred more than 6 months prior to the effective date of coverage. These conditions cannot be excluded beyond 6 months after the policy is issued.)

The individual most likely to buy a Medicare Supplement policy would be a(n)

68-year old male covered by Medicare

Emergency health care coverage for Medicare enrollees traveling abroad is

A Medicare Supplement additional benefit

Which of the following will a Long-Term Care plan typically provide benefits for?

Home health care A Long-Term Care policy will typically pay for home health care.

Andy is in need of health care performed by skilled medical practitioners, but only on an intermittent basis. What level of care will his doctor likely prescribe?

Intermediate care

Nursing home benefits must be provided for at least 12 consecutive months in which of the following types of policies: 1) Blanket custodial 2) Long-Term Care 3) Critical Illness 4) Medicare Supplements

Long-Term Care Long-Term Care policies are designed to provide nursing home benefits on an extended basis of at least twelve consecutive months.

If a retiree on Medicare required five hospital stays in one year, which policy would provide the best insurance for excess hospital expenses?

Medicare Supplement

Medicare Supplement insurance requires an individual to be at least how old for open enrollment?

No minimum age

Long-term care policies normally cover expenses associated with

Nursing Homes

When dealing with long-term care coverage, what would be classified as ADLs?

eating, bathing, dressing, and mobility

Employer-paid qualified long-term care insurance premiums are typically

excluded from the employee's gross income

Medicare Part B does NOT cover?

inpatient hospital services Medicare Part B is a voluntary program designed to provide supplementary medical insurance to cover physician services, medical services, and supplies not covered under Part A.

A Medicare Supplement policy is required to

provide a 30-day free-look period

Which Long Term Care insurance statement is true?

"Pre-existing conditions must be covered after the coverage has been in force for six months". (Pre-existing conditions are those for which medical advice or treatment was recommended by or received from a health provider within 6 months preceding the effective date of an individual long-term care policy.)

What is the MINIMUM number of Activities of Daily Living (ADL) an insured must be unable to perform to qualify for Long Term Care benefits?

2 A qualified Long Term Care policy must stipulate that the insured be incapable of performing at least two of the ADL's without assistance for at least 90 days to qualify for benefits.

How long is the typical free look period for Long Term care insurance policies?

30 days . (Most Long Term Care policies require a 30-day free look period.

A reimbursement policy pays what amount of covered Long-Term Care expenses?

Actual covered expenses up to the daily maximum A reimbursement policy pays the actual covered expenses up to the daily maximum.

Which of the following types of care is typically not covered in a Long-Term Care policy?

Acupuncture

Under a Long Term Care policy, which benefit would be typically excluded or limited?

Alcohol rehabilitation Addictive behavior rehabilitation is normally excluded or limited under a Long Term Care policy.

The guarantee of insurability option provides a long-term care policyowner the ability to

Buy addition coverage at a later date

What type of doctor-ordered care assists an individual with performing basic daily activities such as bathing, dressing, and eating?

Custodial care

Long Term Care policies will usually pay for eligible benefits using which of the following methods?

Expense incurred

Under a long-term care inflation rider, the benefit levels

Periodically increase without proof of insurability

Which would NOT be a location where skilled nursing care is provided?

Personal Residence

Home health care benefits typically do NOT include coverage for

Prescription Medication

Qualified long-term care premiums are treated for tax purposes as

Tax-deductible to the extent they exceed 7 1/2% AGI

Medicare supplement insurance that provides a preventative medical care benefit will often cover

Yearly Physical Examinations