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.All 6 of 6
b.1 of 6
c.3 of 6
d.2 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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Reviewed by John Zihao Zhang California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 verify)
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