Which is a requirement of an insurer who offers long-term care policies quizlet?
Asked by: Baron Fritsch | Last update: February 11, 2022Score: 4.6/5 (11 votes)
All insurers offering long-term care policies must offer policyholders the option to buy a policy with inflation protection. Inflation protection is an optional benefit that provides for automatic annual increases in benefits based on a cost-of-living adjustment (COLA).
Which of the following provisions must be included in a long term insurance policy?
Which of the following provisions must be included in a long-term insurance policy? The Health Insurance Portability and Accountability Act (HIPAA) mandated that all long-term care policies must be guaranteed renewable.
Which one of the following persons is the best candidate for LTCI?
Who would be the most likely candidate for purchasing a LTC policy? Those who have the resources to pay the premiums. Long term care is especially needed when an elderly person requires assistance with activities of daily living due to: Physical or cognitive impairments.
Which of the following is one of the six ADL?
The six standard ADLs are bathing, dressing, toileting, transferring (moving to and from a bed or a chair), eating, and continence. If you cannot perform a certain number of ADLs (usually two of the six) without substantial help from another person, you are eligible for benefits under long-term care coverage.
Which of the following is a common benefit trigger for long-term care policy benefits?
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.
4 Tips to Buying Long Term Care (LTC) Insurance
What is long term care insurance and who needs it?
Long-term care insurance usually covers all or part of assisted living facilities and in-home care for people 65 or older or with a chronic condition that needs constant care. It is private insurance available to anyone who can afford to pay for it.
What is a benefit trigger under long term care insurance policy?
Benefit triggers: Are the criteria insurance policies use to determine if you are eligible for long-term care benefits. Are determined through a company sponsored nurse/social worker assessment of your condition. Usually are defined in terms of Activities of Daily Living (ADLs) or cognitive impairments.
Which of the following must an insurer develop in order to market long term care insurance?
10234.95. (a) Every insurer or other entity marketing long-term care insurance shall: (1) Develop and use suitability standards to determine whether the purchase or replacement of long-term care insurance is appropriate for the needs of the applicant. (2) Train its agents in the use of its suitability standards.
What does custodial long-term care primarily consist of?
Custodial care is non-medical care provided to assist people with daily living. Custodial-care services may include bathing, cooking, cleaning, and other necessary functions. Medicare and Medicaid both partially cover custodial care services, but only in specific situations and conditions.
What is ADLs in medical term?
The activities of daily living (ADLs) is a term used to collectively describe fundamental skills required to independently care for oneself, such as eating, bathing, and mobility.
What is the primary goal of long-term care?
While the primary goal of acute care is to return an individual to a previous functioning level, long-term care aims to prevent deterioration and promote social adjustment to stages of decline.
What do long-term care policies offer to policyholders to account for inflation?
What do long-term care policies offer to policyholders to account for inflation? They offer the option of purchasing coverage that raises benefit levels accordingly.
What is the minimum benefit period that must be offered by a long-term care policy quizlet?
Long-term care insurance policies provide coverage for at least 12 months.
Which three levels of care are long-term care policies provided with?
Continuing Care Retirement Communities (CCRCs) - Includes three levels of care: independent, assisted living and skilled nursing care.
Which of the following may be excluded from long-term care coverage?
All of the following medical conditions are excluded from coverage under a long-term care policy EXCEPT: Drug dependence. Preexisting conditions. Alcoholism.
Which of the following types of care is excluded in a long-term care policy?
Most long-term care insurance policies permanently exclude benefits being paid for certain conditions. Watch out for common conditions excluded, such as certain forms of heart disease, cancer or diabetes. Other exclusions include: Mental or nervous disorders, not counting Alzheimer's or other dementia.
Which Medigap policy covers long-term custodial care?
Since most long-term care for seniors is not covered by Medicare, this is a considerable “gap”. However, even the most comprehensive of the Medigap plans does not cover long-term care needs for the elderly. These policies do not pay for assisted living, Alzheimer's, custodial (personal care), or adult day care.
What are examples of custodial care?
This document defines custodial care, a type of care that generally provides assistance in performing activities of daily living (ADL); for example, assistance walking, transferring in and out of bed, bathing, dressing, using the toilet, preparation of food, feeding and supervision of medication that usually can be ...
What is a functional assessment for long-term care benefits?
Functional assessment tools are sets of questions about an applicant's health conditions and functional needs that state Medicaid programs use to determine functional eligibility for long- term services and supports (LTSS) and to create specific care plans for eligible individuals.
How long must an insurer retain an advertisement for its long-term care policies?
How long must an insurer retain an advertisement for its long term care policies? The insurance company must retain all advertisments for at least three years from the data that the advertisement was first used.
How long must an insurer keep books and records?
(d) Except as otherwise provided, the records shall be maintained for a minimum period of five years following the actual delivery of the insurance policy or contract to which each pertains, or, if no policy or contract was issued, for a minimum period of five years after the date of the application therefor.
How long does long-term care insurance last?
Long-term care (LTC) policies are typically sold for 12 or more months of care. You can buy a policy that pays benefits for only 1 year or one that pays for 2, 3 or 5 years. Companies have stopped selling benefits for as long as you live.
Which of the following is not a trigger for eligibility for long-term care benefits?
Which of the following is not a benefit trigger under long-term care policies? Financial need is not a benefit trigger for long-term care policy benefits.
What is necessary in order to be eligible to receive benefits from a long-term care policy quizlet?
Normally to be eligible for benefits from a long-term care policy, the insured must be unable to perform some of their activities of daily living (ADLs). ADLs include bathing, dressing, toileting, transferring, continence, and eating.
Which of the following will a long-term care plan typically provide benefits for quizlet?
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.