No longterm care insurance policy may be delivered or issued for delivery in this state if the policy:

(1) Conditions eligibility for any benefits on a prior hospitalization requirement;

Terms Used In South Dakota Codified Laws 58-17B-7

  • State: when used in context signifying a jurisdiction other than the State of South Dakota, a state, the District of Columbia, a territory, commonwealth, or possession of the United States of America, or a province of the Dominion of Canada. See South Dakota Codified Laws 58-1-2

(2) Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or

(3) Conditions eligibility for any benefits other than waiver of premium, postconfinement, postacute care or recuperative benefits on a prior institutionalization requirement.

Postconfinement, postacute care, or recuperative benefits do not include home health care, adult day care, or any other benefit based on treatment or services received.

A longterm care insurance policy, continuing postconfinement, postacute care, or recuperative benefits, shall clearly label, in a separate paragraph of the policy or certificate entitled “Limitations or Conditions on Eligibility for Benefits,” such limitations or conditions, including any required number of days of confinement.

A longterm care insurance policy or rider which conditions eligibility of noninstitutional benefits on the prior receipt of institutional care may not require a prior institutional stay of more than thirty days, except waiver of premium which may not require a prior institutional stay of more than ninety days.

Source: SL 1989, ch 440, § 7; SL 1991, ch 401.