Final view - long term care

5: In a shared-care policy, the benefits of 2 LTC policies

A Are multiplied according to the number of people in the contract.

B Can be divided by as many as 5 people.

C Go to the couple if they get sick at the same time and share resources.

D Are split between the couple who signed the contract.

In a shared care policy, a couple pools the benefits of two LTC policies, and splits them. If 2 people buy two 5-year policies, they have a total of 10 years of LTC.

7: Guarantee of insurability option in long-term care policies allows the insured to

A Secure the policy’s nonforfeiture values regardless of the insured’s age or health status

B Increase benefit levels without providing proof of insurability

C Add dependents to the plan without providing proof of their insurability

D Replace the existing LTC policy based on the original underwriting

Guarantee of insurability option allows the insured to periodically increase benefit levels without providing evidence of insurability.

12: Which of the following long-term care benefits would provide coverage for care for functionally impaired adults on a less than 24-hour basis?

A Adult day care

B Residential care

C Assisted living

D Home health care

Adult day care is designed for those who require assistance with various ADLs on a daily basis, but not around the clock. Custodial care is usually the only service provided by adult day care facilities.

14: Which of the following types of LTC is NOT provided in an institutional setting?

A Home health care

B Custodial care

C Skilled nursing care

D Intermediate care

Home health care is given in the home, but skilled nursing, intermediate, and custodial care may all be provided in an institutional setting.

Chapter Recap

This chapter explained long-term care insurance, including types of care, required benefits, and state-specific regulations pertaining to LTC policies. Let's recap some of the key points:

LONG-TERM CARE
Policies	Available as individual policies, group policies, or as riders to life insurance policies  Coverage for individuals who require living assistance at home or in a nursing home facility Must provide at least 12 months of consecutive coverage in a setting other than an acute care unit of a hospital Guaranteed renewable, but insurers may increase premiums
Levels of Care	Skilled care - daily nursing and rehabilitative care provided by medical personnel Intermediate care - occasional nursing or rehabilitative care provided for stable conditions that require daily medical assistance on a less frequent basis than skilled nursing care  Custodial care - care for a person's activities of daily living provided in an institutional setting or in the patient's home Home health care - provided by registered nurses, licensed practical nurses, licensed vocational nurses, or community-based organizations like hospice in one’s home Residential Care - provided while the insured resides in a retirement community Adult day care - provides for functionally impaired adults on less than a 24-hour basis  Respite Care - provides relief to the family caregiver; adult day care centers may also provide this type of relief Assisted living - provides help with nonmedical daily activities
Coverage and Benefits	12 consecutive months Elimination period of 30 days or more Benefit period of 2-5 years; some offering lifetime coverage Longer benefit periods result in higher premium Trigger: inability to perform ADLs (usually 2 - 3)
Required Provisions	Must be guaranteed renewable Must offer inflation protection Free look period - 30 days Pre-existing conditions exclusion - no more than 6 months Must cover Alzheimer's disease Disclosure requirements - outline of coverage and policy summary

Most LTC plans have which of the following features?

A Variable premiums

B Open enrollment

C Guaranteed renewability

D No elimination period

The benefit amount payable under most LTC policies is usually a specific amount per day, and some policies pay the actual charge incurred per day. Most LTC policies are also guaranteed renewable; however, insurers do have the right to increase the premiums.

6: What option allows the insured to periodically increase benefit levels without providing evidence of insurability?

A Guarantee of insurability

B Guarantee renewable

C Annual increase

D Level premium

Guarantee of insurability option allows the insured to periodically increase benefit levels without providing evidence of insurability. The amount is usually limited to allowing a 5% compounded annual increase.

11: Which of the following types of LTC is NOT provided in an institutional setting?

A Home health care

B Custodial care

C Skilled nursing care

D Intermediate care

Home health care is given in the home, but skilled nursing, intermediate, and custodial care may all be provided in an institutional setting.