When an elimination period is associated with LTC insurance it means that quizlet?

(1) Many words or terms cannot be used in a policy unless they are specifically defined in accordance with the legislation and, for example, adult day care, home health care services, personal care, and skilled-nursing care.

(2) Renewal provisions must be either guaranteed renewable or noncancelable.

(3) Limitations and exclusions are prohibited except in the cases of preexisting conditions

(4) No policy can provide coverage for skilled-nursing care only or provide significantly more coverage for skilled care in a facility than for lower levels of care.

(5) The definition of preexisting condition can be no more restrictive than to exclude a condition for which treatment was recommended or received within 6 months prior to the effective date of coverage. In addition, coverage can be excluded for a confinement for this condition only if it begins within 6 months of the effective date of coverage.

(6) Eligibility for benefits cannot be based on a prior hospital requirement or higher level of care.

(7) must offer the applicant the right to purchase coverage that allows for an increase in the amount of benefits based on reasonable anticipated increases in the cost of services covered by the policy. The applicant must specifically reject this inflation protection if he or she does not want it.

(8) right to purchase a nonforfeiture benefit. If the applicant declines the nonforfeiture benefit, the insurer must provide a contingent benefit upon lapse that is available for a specified period of time following a substantial increase in premiums.

(9) must contain a provision that makes a policy incontestable after 2 years on the grounds of misrepresentation. The policy can be contested on the basis that the applicant knowingly and intentionally misrepresented relevant facts pertaining to the insured's health.

Functions or activities which are performed by individuals without assistance, thus allowing personal independence in everyday living.

Ex) dressing, eating, bathing, maintaining continence, transferring, and toiling

-If an insured is unable to perform 2 or more ADL's and/or have a cognitive impairment they are considered to be chronically ill

-Contains a 30 day free look policy