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.

Terms Used In Arizona Laws 20-1691.05

  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • including: means not limited to and is not a term of exclusion. See Arizona Laws 1-215
  • Long-term care insurance: means an individual or group insurance policy or rider issued by insurers, fraternal benefit societies, nonprofit health, hospital and medical service corporations, prepaid health plans, health care services organizations or any similar organization and advertised, marketed, offered or designed to provide coverage for each covered person on an expense-incurred, indemnity, prepaid or other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, personal or custodial care services provided in a setting other than an acute care unit of a hospital. See Arizona Laws 20-1691
  • Policy: means an individual or group policy, contract, subscriber agreement, rider or endorsement delivered or issued for delivery in this state by an insurer, fraternal benefit society, nonprofit health, hospital or medical service corporation, prepaid health plan or health care services organization or any similar organization. See Arizona Laws 20-1691

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.

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