WebCE: Long-Term Care: Programs, Policies, and Partnerships Exam

What is the Primary Goal of Long Term Care - Answer- To maintain functionality Which of the following most precisely defines the fundamentals of self-care and the basic tasks of life? - Answer- Activities of daily living Long Term Care occurs only in nursing facilities. - Answer- False On what basis are benefits payable under a long term care insurance policy typically triggered? - Answer- the inability to perform defined ADLs A long-term care ombudsman represents people in a given geographical area who live in assisted living residences or skilled nursing facilities. - Answer- True Which level of care has as its chief characteristic assistance with ADLs? - Answer- Custodial All of the following are examples of formal caregiving EXCEPT: - Answer- Daily transportation to a senior center provided by a neighbor. All of the following are services commonly offered by assisted living residences EXCEPT: - Answer- Continuous post-operative monitoring. Which of the following is not an example of home or community-based long-term care? - Answer- CCBSs Medicare covers the cost of long-term custodial care in the home when it is delivered by a Medicare-certified agency. - Answer- False Which of the following is a correct statement about Medicare? - Answer- Medicare does not cover long-term care. Which of the following only covers inpatient hospital care and hospice? - Answer- Medicare Part A With regard to Medicare and long-term care, which of the following statements is true? - Answer- Medicare covers care in a skilled nursing facility for a limited time, but only if the care follows an admitted hospital stay and is ordered by a physician. Which of the following is a correct statement about Medicare Part D Prescription Drug coverage? - Answer- Enrollment in Part D is voluntary. The federal government: - Answer- Gives states flexibility in administering their Medicaid Programs How much of a community spouse's own income must be spent on care for an institutionalized spouse who is receiving Medicaid assistance? - Answer- Not: all of it 50% 25% None of the income that a community spouse receives in his or her name, such as wages or Social Security or a pension, must be diverted to the cost of care for the institutionalized spouse. A burial plot is exempt when determining Medicaid eligibility. - Answer- True Medicaid is available to pay for LTC expenses for anyone without LTC insurance. - Answer- False Of the factors below, which does state review to determine a person's eligibility for Medicaid? - Answer- I. Assets II. Income Under current Medicaid rules, what is the look-back period for the transfer of assets? - Answer- 60 months Long-term care insurance policies are easy to compare and contrast. - Answer- False An insurance company can increase the premiums on its LTCI policies after policy inception if the insured's health declines. - Answer- False All of the following may deduct the full cost of their qualified LTCI premiums, subject to the age-based limits, EXCEPT: - Answer- Employees whose premiums are paid by their employers Group LTCI policies are contracts between the insurance company and each individual member of the group. - Answer- Fasle Which of the following sets forth the length of time an LTCI policy will pay benefits? - Answer- the benefit period A guaranteed renewable LTCI policy provides coverage must be continued as long as premiums are paid. - Answer- True Marcus purchases a long-term care insurance policy at age 45. Which of the following will give him the most protection against the rising cost of long-term care? - Answer- Inflation protection Which of the following best describes the elimination period in an LTCI policy? - Answer- It is a waiting period before benefits begin. After being effectively frozen in place for a number of years, state LTC partnership programs were allowed to expand as a result of what legislation? - Answer- DRA 2005 Who (or what) pays the largest share of total long-term care expenses in the U.S.? - Answer- Medicaid All of the following statements regarding the benefits of state LTC partnership programs are generally correct EXCEPT: - Answer- The federal Medicare program benefits by reducing demand for acute long-term care among seniors. As defined by the Deficit Reduction Act of 2005, an insured who participates in a new state partnership program may be eligible for an exemption to Medicaid's asset spend-down rule equal to what amount? - Answer- the total lifetime benefits payable through the LTC partnership policy. Gerald purchased a partnership-qualified LTCI policy that provides coverage for both nursing facility care and home and community-based care. The daily nursing facility benefit is $150. The total benefit available for home and community care under this policy must be at least what amount? - Answer- $27,375 As required by DRA, all long-term care insurance policies used in any new state partnerships programs must be tax qualified as defined by HIPAA. - Answer- True All of the following statements regarding minimum standards for partnership-qualified long term care insurance policies are correct EXCEPT: - Answer- Inflation protection is optional for all applicants At a minimum, what must partnership-qualified long-term insurance policies? - Answer- Guaranteed renewable What federal law defined tax qualified long-term care insurance policies? - Answer- Health Insurance Portability and Accountability Act of 1996 In defining the term and conditions for a qualified state long-term care insurance partnership program, DRA outlines basic requirements for partnership-qualified LTCI policies in all of the following respects EXCEPT: - Answer- Maximum allowable premiums Because taking a withdrawal from the cash value of a life insurance policy is always a taxable event, this technique should not be used to fund long-term care needs. - Answer- False Which of the following refers to the sale of an in-force life insurance policy by a terminally ill insured to a third party for an amount less than the policy's death benefit? - Answer- Viatical settlement A disadvantage to using a conventional deferred annuity to fund late-life long-term care needs is that the contract must be annuitized, and payments must be made over a stated number of years or for life. - Answer- False All of the following are sound reasons for purchasing life insurance EXCEPT: - Answer- Funding anticipated LTC expenses In reverse mortgage, a homeowner receives money from the lender. - Answer- True A health saving account (HSA) is used in conjunction with which of the following? - Answer- High-deductible health insurance plan A hybrid annuity combines a fixed deferred annuity product with which of the following? - Answer- A long-term care rider Under the NAIC Long-Term Care Model Act as well as many state insurance regulations, who is primarily responsible for instituting good suitability practices? - Answer- Producers and insurance companies equally Misrepresenting a long-term care policy pertains only to statements the producer makes or literature he or she delivers. - Answer- False All of the following are steps in the needs-based selling approach EXCEPT: - Answer- Engaging in fair competition What is the basic purpose of a suitability letter sent from an insurance company to a long-term care policy applicant? - Answer- To inform the applicant that the insurer is questioning the suitability of the applied-for policy, briefly explaining why, and asking the applicant to advise the insurer on whether it should proceed with the underwriting and issue process