Current through the 2023 Legislative Sessions
Section 26.1-45-07 - Prior institutionalization requirement prohibited1. No long-term care insurance policy or certificate may be delivered or issued for delivery in this state if such policy:a. Conditions eligibility for any benefits on a prior hospitalization requirement.b. Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of such institutional care.c. Conditions eligibility for any benefits other than waiver of premium, postconfinement, postacute care, or recuperative benefits on a prior institutionalization requirement.2.a. A long-term care insurance policy containing postconfinement, postacute care, or recuperative benefits must clearly label in a separate paragraph of the policy or certificate entitled "limitations or conditions on eligibility for benefits" such limitations or conditions, including any required number of days of confinement.b. A long-term care insurance policy or rider which conditions eligibility of noninstitutional benefits on the prior receipt of institutional care may not require a prior institutional stay of more than thirty days.3. No long-term care insurance policy or rider which provides benefits only following institutionalization may condition such benefits upon admission to a facility for the same or related conditions within a period of less than thirty days after discharge from the institution.