Sec. 21.53.040. Prior hospital or institutional care conditions prohibited.
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Sec. 21.53.040. Prior hospital or institutional care conditions prohibited.
(a)A long-term care insurance policy may not be delivered or issued for delivery in this state if the policy conditions eligibility
(1)on a prior hospitalization requirement;
(2)on the receipt of a higher level of institutional care, when care is provided in an institutional setting;
(3)for noninstitutional benefits on a prior institutional stay of more than 30 days for which benefits are paid;
(4)on admission to an institutional care facility for the same or a related condition within a period of less than 30 days after discharge from the institution, if the policy provides benefits only following institutionalization; or
(5)for a benefit, other than a waiver of premium, postconfinement, postacute care, or recuperative benefit, on a prior institutionalization.
(b)A long-term care insurance policy containing a postconfinement, postacute care, or recuperative benefit must clearly label the limitations or conditions, including any required number of days of confinement, “Limitations or Conditions on Eligibility for Benefits” in a separate paragraph of the policy.