Disability & Long-Term CareQuestion 93 of 315

Under a tax-qualified long-term care policy, an insured normally becomes eligible for benefits when they are unable to perform without substantial assistance how many of the six activities of daily living (ADLs)?

a.1 of 6
b.2 of 6
c.3 of 6
d.All 6 of 6

Explanation

The HIPAA standard, used by tax-qualified LTC policies and California's LTC framework, triggers benefits when the insured cannot perform at least 2 of the 6 ADLs (bathing, dressing, eating, toileting, transferring, continence) without substantial assistance for an expected period of at least 90 days. Severe cognitive impairment is a separate, independent trigger.

Law Reference: HIPAA tax-qualified LTC standard; Cal. Ins. Code §10232.8

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