20-1691.05. Prior institutionalization

A. A long-term care insurance policy delivered or issued for delivery in this state on or after July 1, 1990 shall not condition availability of benefits on prior hospitalization.

B. A long-term care insurance policy delivered or issued for delivery in this state on or after the effective date of this amendment to this section shall not:

1. Condition eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care.

2. Condition eligibility for any benefits, other than waiver of premium, postconfinement, postacute care or recuperative benefits, on a prior institutionalization requirement.

C. A long-term care insurance policy containing postconfinement, postacute care or recuperative benefits shall clearly label, in a separate paragraph of the policy that is entitled "limitations on benefits", any limitations or conditions, including any required number of days of confinement.

D. A long-term care insurance policy or rider that conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than thirty days.

E. A long-term care policy that provides benefits only following institutionalization shall not condition the benefits on admission to a facility for the same or related conditions within a period of less than thirty days after discharge from the institution.

20-1691.05. Prior institutionalization

A. A long-term care insurance policy delivered or issued for delivery in this state on or after July 1, 1990 shall not condition availability of benefits on prior hospitalization.

B. A long-term care insurance policy delivered or issued for delivery in this state on or after the effective date of this amendment to this section shall not:

1. Condition eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care.

2. Condition eligibility for any benefits, other than waiver of premium, postconfinement, postacute care or recuperative benefits, on a prior institutionalization requirement.

C. A long-term care insurance policy containing postconfinement, postacute care or recuperative benefits shall clearly label, in a separate paragraph of the policy that is entitled "limitations on benefits", any limitations or conditions, including any required number of days of confinement.

D. A long-term care insurance policy or rider that conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than thirty days.

E. A long-term care policy that provides benefits only following institutionalization shall not condition the benefits on admission to a facility for the same or related conditions within a period of less than thirty days after discharge from the institution.