58-17B-7 Requirements for long-term care insurance policies--Post-confinement, post-acute care, or ...
Requirements for long-term care insurance policies--Post-confinement, post-acute
care, or recuperative benefits.
No long-term care insurance policy may be delivered or issued for
delivery in this state if the policy:
Conditions eligibility for any benefits on a prior hospitalization requirement;
Conditions eligibility for benefits provided in an institutional care setting on the receipt
of a higher level of institutional care; or
Conditions eligibility for any benefits other than waiver of premium, post-confinement,
post-acute care or recuperative benefits on a prior institutionalization requirement.
Post-confinement, post-acute care, or recuperative benefits do not include home health care, adult
day care, or any other benefit based on treatment or services received.
A long-term care insurance policy, continuing post-confinement, post-acute care, or recuperative
benefits, shall clearly label, in a separate paragraph of the policy or certificate entitled "Limitations
or Conditions on Eligibility for Benefits," such limitations or conditions, including any required
number of days of confinement.
A long-term care insurance policy or rider which conditions eligibility of non-institutional
benefits on the prior receipt of institutional care may not require a prior institutional stay of more
than thirty days, except waiver of premium which may not require a prior institutional stay of more
than ninety days.
Source: SL 1989, ch 440, § 7; SL 1991, ch 401.