Long-Term Care Policies

Question 1

Medicare, Medicaid, and LTC:

Answer 1

Medicare and Medigap don’t cover long-term custodial care.
Medicaid covers nursing home care for low-income individuals

Question 2

Disclosure Requirements:

Answer 2

Renewability provisions and riders must be disclosed.
Explanation of terms like “usual and customary.”
Requirement for a Medicare Supplement Shopper’s Guide.

Question 3

Marketing and Advertising:

Answer 3

Fair and accurate comparison of policies.
Prohibition on high-pressure tactics and misleading advertising.

Question 4

Policy Standards and Required Provisions

Answer 4

Prohibited cancellation based on age or health.
Limitation on pre-existing condition definition.
Requirement for inflation protection feature.

Question 5

Additional Terminology:

Answer 5

Activities of Daily Living (ADLs) criteria.
Continuing Care Retirement Communities (CCRC).
Alternate Plans of Care and Hospice Care.

Question 6

Replacement:

Answer 6

Waiver of pre-existing conditions for replacing policies.

Question 7

LTC Partnership:

Answer 7

Allows easier Medicaid qualification for those with private LTC benefits.
Encourages LTC insurance purchase and reduces Medicaid spending.