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Illinois Statutes Chapter 215. Insurance § 5/351A-6. Prior hospitalization; Institutionalizations

Current as of January 01, 2025 | Updated by Findlaw Staff

§ 351A-6. Prior hospitalization; institutionalizations. (a) On and after the effective date of this amendatory Act of 1989, no long-term care insurance policy may be delivered or issued for delivery in this State if such policy:

(1) conditions eligibility for any benefits on a prior hospitalization requirement; or

(2) conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care.

(b) Beginning one year after the effective date of this amendatory Act of 1989, a long-term care insurance policy containing any limitations or conditions for eligibility other than those prohibited above in subsection (a) shall 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.

(1) A long-term care insurance policy containing a benefit advertised, marketed or offered as a home health care or home care benefit may not condition receipt of benefits on a prior institutionalization requirement.

(2) A long-term care insurance policy which conditions eligibility of non-institutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than 30 days for which benefits are paid.

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Cite this article: FindLaw.com - Illinois Statutes Chapter 215. Insurance § 5/351A-6. Prior hospitalization; Institutionalizations - last updated January 01, 2025 | https://codes.findlaw.com/il/chapter-215-insurance/il-st-sect-215-5-351a-6/

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