Long Term Care Chapter 21 Flashcards
What is the definition of pre-existing condition in a long term care policy?
A. any health condition that existed before coverage was in force
B. a condition for which advice or treatment was received within 3 months before the effective date of coverage
C. a condition for which advice or treatment was received within 1 year before the effective date of coverage
D. a condition for which advice or treatment was received within 6 months before the effective date of coverage
D
Which of the following statements explains why a person would not be a good applicant for a long-term care insurance policy?
A. because of his financial situation, he must rely on medicaid to pay the cost of long term care
B. he has substantial savings put aside to cover the cost of long term care
C. he already has a long term disability policy
D. he has a medicare supplement policy that will cover the cost of long term care
A
Which of the following statements regarding home health care is not correct?
A. the services provided under home health care include physical therapy and certain types of custodial care
B. home health care is an extension of intermediate custodial care
C. the care needed is able to be provided without the insured having to be confined to a nursing home
D. most long term care policies do not provide coverage for home health care
D
Which of the following statements about long term care coverage is correct?
A. long term care insurance provides a broad range of coverage for services rendered at home, at adult care centers, or in nursing homes
B. medicare and medicaid are designed to cover a significant portion of the costs of long term custodial or nursing care
C. medicaid provides long term care coverage for individuals, regardless of income levels
D. medicare supplement policies provide a significant amount of long term care coverage
A
Javier purchased a long term care insurance policy with an optional benefit that provides a yearly increase in benefits. His policy offers
A. an insurability option
B. nonforfeiture benefits
C. inflation protection
D. a return of benefits option
C
A long term care policy can be terminated because of the insureds
A. age
B. nonpayment of premiums
C. deterioration of mental capacity
D. loss of physical capability
B
An optional benefit that allows an insured to buy additional coverage at certain times using their attained age is
A. guaranteed insurability
B. inflation protection
C. guaranteed benefits
D. nonforfeiture benefits
A
Regarding long term care insurance, the existence of symptoms that would cause an ordinarily prudent person to seek diagnosis or treatment, or a condition for which medical advice or treatment was recommended by or received from a provider of health care services within 6 months before the effective date of an insureds coverage is known as
A. the 6 month rule
B. a pre-existing condition
C. previous symptoms
D. a pre-coverage warranty
B
All of the following are activities of daily living except
A. dressing
B. reading
C. eating
D. bathing
B
Which of the following statements regarding the elimination period in a long-term care policy is not true?
A. the longer the elimination period, the higher the premium
B. the elimination period can be considered a time deductible
C. the insured selects the length of the elimination period
D. the longer the elimination period, the lower the premium
A
All of the following are required long-term care insurance standards except
A. providing a shoppers guide and an outline of coverage
B. requiring an applicant to sign a notice regarding replacement, if necessary
C. a 10-day free look period
D. a clearly visible notice on the policy that is guaranteed renewable
C
Long-term care policies can limit or exclude coverage for all of the following except
A. alcoholism or drug addiction
B. a family history of a heart condition
C. self-inflicted injuries
D. treatment provided without cost to the insured
B
Which of the following statements regarding the required provisions in a long-term care policy is not true?
A. benefit amounts are expressed as dollars per day
B. the elimination period is considered a time deductible
C. prior hospitalizations is required for payment of benefits
D. policies must provide coverage for a minimum of 12 months
C
All of the following are types of care defined in long-term care insurance policies except
A. adult day care
B. respite care
C. home health care
D. home day care
D
A long-term care policy cannot limit or exclude coverage for which of the following conditions?
A. intentionally self-inflicted injuries
B. service provided outside the united states
C. alzheimers disease
D. mental disorders
C
For a long-term care insurance policy to begin paying benefits, the insured must
A. be diagnosed as terminally ill
B. be diagnosed as chronically ill
C. be hospitalized for at least 3 days
D. receive skilled nursing care for at least 3 days
B
Which of the following terms describes the ability to perform certain independent tasks?
A. activities of daily tasks
B. listing of daily activities
C. daily tasks of living
D. activities of daily living
D
A qualified long-term care insurance policy must contain which of the following requirements?
A. coverage for drug and alcohol dependency
B. guaranteed renewability
C. coverage for conditions that result from war
D. a probationary period of no longer than 180 days
B
An insurance policy benefit that increases benefits to keep up with anticipated cost increases for long-term care services is said to have
A. inflation protection
B. loss of income protection
C. guaranteed benefits
D. medicare supplemental protection
A
Which of the following is not one of the six activities of daily living?
A. shopping
B. dressing
C. bathing
D. eating
A
