Restricted conditional terms.

Checkout our iOS App for a better way to browser and research.


  • (1) A long-term care insurance policy may not contain a provision that conditions eligibility:
    • (a) for any benefits on a prior hospitalization requirement;
    • (b) for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or
    • (c) for any benefits on a prior institutionalization requirement except for eligibility for:
      • (i) waiver of premium;
      • (ii) post confinement;
      • (iii) post-acute care; or
      • (iv) recuperative benefits.
  • (2) A long-term care insurance policy containing post confinement, post-acute care, or recuperative benefits shall clearly label the limitations or conditions, including any required number of days of confinement in a separate paragraph of the policy or certificate that is entitled "Limitations or Conditions on Eligibility for Benefits."
  • (3) A long-term care insurance policy or rider that conditions eligibility of noninstitutional benefits on the prior receipt of institutional care may not require a prior institutional stay of more than 30 days.




Download our app to see the most-to-date content.