Disability & Long-Term CareQuestion 95 of 315

An insured has advanced Alzheimer's disease and can still physically perform all six activities of daily living without assistance. Are they eligible for benefits under a tax-qualified long-term care policy?

a.No, because they can still perform all six ADLs
b.No, because cognitive impairment is not a benefit trigger
c.Yes, because severe cognitive impairment is an independent benefit trigger
d.Yes, but only if a family member also signs as caregiver

Explanation

Tax-qualified LTC policies use two independent benefit triggers: inability to perform at least 2 of 6 ADLs, or severe cognitive impairment requiring substantial supervision to protect the insured's health and safety. Advanced Alzheimer's disease qualifies under the cognitive-impairment trigger by itself.

Law Reference: HIPAA tax-qualified LTC standard

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