Long-Term Care Insurance Flashcards
6 cards from real Life and Health California Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Long-Term Care Insurance flashcards as text
Under the Health Insurance Portability and Accountability Act (HIPAA), which individuals can deduct LTC premiums as a medical expense?
Answer: Self-employed individuals and those who itemize, subject to age-based premium limits
HIPAA allows self-employed individuals to deduct 100% of qualifying LTC premiums, and other individuals may deduct age-based eligible premiums as medical expenses when itemizing.
California requires LTC insurers to provide an 'outline of coverage' to applicants:
Answer: At the time of application, before the policy is issued
California law requires LTC insurers to deliver an outline of coverage to applicants at the time of application so they can make informed purchasing decisions before committing.
Under California LTC insurance regulations, the free-look (right to return) period for individual LTC policies is at least:
Answer: 30 days
California requires a minimum 30-day free-look period for individual LTC policies, during which the purchaser may return the policy for a full refund of premium.
What is the primary purpose of the 'alternate plan of care' provision in an LTC policy?
Answer: To allow the insurer and insured to agree on covered care not originally listed in the policy
An alternate plan of care provision allows the insurer and insured (and their physician) to mutually agree to pay for innovative or emerging care options not explicitly listed in the original policy.
Which of the following triggers is unique to tax-qualified LTC policies and is NOT found in non-tax-qualified LTC policies?
Answer: Inability to perform 2 of 6 ADLs expected to last at least 90 days
Tax-qualified LTC policies specifically require a 90-day certification period for ADL deficits; non-qualified policies may use medical necessity as a trigger without the 90-day requirement.
California's 'senior insurance' rules require that LTC insurers use which standard when replacing existing LTC coverage?
Answer: The replacing insurer must ensure the new policy is at least as favorable to the insured as the replaced policy
Under California replacement regulations, the replacing insurer must ensure the new LTC policy provides at least comparable benefits to the replaced policy to protect consumers from coverage gaps.