What are the two qualifying benefit triggers under a long term care insurance policy?
Asked by: Nina Stehr | Last update: August 15, 2025Score: 4.8/5 (33 votes)
What are two benefit triggers a long-term care policy might have?
Benefit Triggers
In California, insurance companies must pay LTC benefits when you cannot perform 2 activities of daily living (such as bathing, dressing or eating) or you have a cognitive impairment serious enough to require supervision.
What triggers a long-term care event?
Long term care policies typically kick in when an individual needs assistance with two out of six qualifying tasks (generally this includes toileting, bathing, dressing, eating, transferring, and incontinence), but this could vary depending on the specific long term care policy.
What are the benefits of a qualified long-term care policy?
Long term care insurance pays for long term care in places like a nursing home, an assisted living facility, or at home. Many people purchase it to protect their own savings and assets and remain independent in the event they ever need long term care. This type of insurance is medically underwritten.
Which of the following is a benefit trigger under a long-term care insurance policy Quizlet?
Which of the following is a common benefit trigger for a long-term care policy? Cognitive or Mental Impairment. (A benefit trigger is an event or condition that must occur before policy benefits become payable.
What triggers your long-term care insurance policy?
Which of the following does not trigger benefits under a long term care policy?
In long-term care policies, benefit triggers are essential activities that determine eligibility for coverage. Among the options listed, sleeping is not typically considered a benefit trigger, while eating, toileting, and continence are. Therefore, the correct answer is C) Sleeping.
What is a coverage trigger in insurance terms?
A coverage trigger is an event that must occur in order for a liability policy to apply to a loss. Coverage triggers are outlined in the policy language, and courts will use different legal theories pertaining to triggers to determine whether policy coverage applies.
What are the benefits of a qualifying policy?
Qualifying policies are generally long-term policies where regular sums are paid in. There is typically no tax when a qualifying policy matures.
What are the three main types of long-term care insurance policies?
- Standalone (traditional) long-term care insurance.
- Long-term care insurance rider.
- Linked-benefit long-term care insurance.
When using the functional model to trigger LTC benefits?
Explanation: When using the functional model to trigger long-term care benefits, an insurance company should measure the insured's cognitive and physical ability to complete activities of daily living. This includes assessing the person's ability to perform essential self-care tasks.
Which of the following will a long-term care plan typically provide benefits for?
Generally, LTCI policies will, for a specified period of time (called the benefit period), pay a selected dollar amount per day toward skilled, intermediate, or custodial care in nursing homes, assisted-living facilities, or the insured's home.
What are the three major components of long-term care?
The long-term care delivery system has three major components: The informal system. The community-based system. The institutional system.
What are the 5 things for long-term care?
- What's the chance I'll need long-term care? ...
- How much would long-term care cost? ...
- How would I pay for these costs? ...
- What does a typical long-term care policy cover, and what is the best age to consider purchasing one? ...
- What's the No.
What is a medical necessity trigger in LTC?
A medical necessity benefit trigger permits an insured to qualify for long-term care insurance benefits even though he or she suffers no cognitive impairment and is able to perform the usual activities of daily living.
What are 2 benefits of having any type of insurance coverage?
Health insurance protects you from unexpected, high medical costs. You pay less for covered in-network health care, even before you meet your deductible. You get free preventive care, like vaccines, screenings, and some check-ups, even before you meet your deductible.
What are 2 examples of when someone would have to rely on long term disability insurance?
- Deafness or hearing loss.
- Blindness or vision loss.
- Certain long-term injuries.
- Chronic pain.
- Chronic fatigue.
What are the two major types of health policy?
Health Policy Types: Regulatory & Allocation.
What is a functional assessment for long-term care benefits?
Functional assessments are tools that states, providers, and managed care plans use to collect comprehensive information on persons applying for, and participants in, Medicaid home and community-based services (HCBS) and long-term services and supports (LTSS) programs.
What are the 3 C's of long-term care?
Paramount among these are the "3Cs": consistency, continuity, and coordination of patient care.
What are examples of a qualifying event?
- Gaining a dependent or becoming a dependent through birth or adoption.
- Getting married.
- Applicant or dependent lost minimum essential coverage due to termination or change in employment status.
- Cessation of an employer's contribution toward an employee or dependents coverage.
What is qualifying coverage in insurance?
health care law
Qualifying health care coverage, called minimum essential coverage, includes coverage under various, but not all, types of health insurance plans. The majority of health insurance coverage that people have today is minimum essential coverage.
What are the benefits of a policy?
- help organizations maintain consistency and control over their operations.
- help keep the company running smoothly and efficiently.
- help employees know what is expected of them and what they should do in certain situations.
What are the different types of triggers in insurance?
In insurance parlance, a trigger is an event that activates coverage. Courts typically look to the four established trigger theories when making a determination. In addition to the injury-in-fact trigger, there is also an exposure trigger, manifestation trigger, and continuous trigger.
What is a benefit trigger?
Benefit triggers are the criteria that an insurance company will use to determine if you are eligible for benefits. Most companies use a specific assessment form that will be filled out by a nurse/social worker team.
What is a trigger policy?
"Trigger laws" are laws that are passed by a legislative body but only go into effect once a certain thing happens. That specific event will "trigger" it into becoming enforceable law. Trigger laws are often passed so that a law can go into effect as soon as possible once conditions allow.