{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-5205.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-5205.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-5205.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-5205.html"}],"law_id":72116,"edition_id":1,"section_id":72116,"structure_id":15692,"section_number":"38.2-5205","catch_line":"Prior institutionalization","history":"1987, c. 586; 1990, c. 285.","full_text":"A\n\nNo long-term care insurance policy may be delivered or issued for delivery in this Commonwealth if such policy conditions eligibility (i) for any benefits provided in an institutional care setting on the receipt of a higher level of institutional care or (ii) for any benefits on a prior hospitalization requirement.B\n\nA long-term care insurance policy containing any limitations or conditions for eligibility other than those prohibited in subsection A shall clearly label such limitations or conditions, including any required number of days of confinement, in a separate paragraph of the policy or certificate entitled “Limitations or Conditions on Eligibility for Benefits.”C\n\nA 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.D\n\nA long-term care insurance policy which conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than thirty days for which benefits are paid.","order_by":null,"text":{"0":{"id":259847,"text":"No long-term care insurance policy may be delivered or issued for delivery in this Commonwealth if such policy conditions eligibility (i) for any benefits provided in an institutional care setting on the receipt of a higher level of institutional care or (ii) for any benefits on a prior hospitalization requirement.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":259848,"text":"A long-term care insurance policy containing any limitations or conditions for eligibility other than those prohibited in subsection A shall clearly label such limitations or conditions, including any required number of days of confinement, in a separate paragraph of the policy or certificate entitled “Limitations or Conditions on Eligibility for Benefits.”","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":259849,"text":"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.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":259850,"text":"A long-term care insurance policy which conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than thirty days for which benefits are paid.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C"}},"ancestry":[{"id":15692,"edition_id":1,"name":"Long-Term Care Insurance","identifier":"52","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:57:59","date_modified":"2026-06-26 03:57:59","permalink":{"id":217773,"object_type":"structure","relational_id":15692,"identifier":"52","token":"38.2\/52","url":"\/38.2\/52\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":81666,"structure_id":15692,"section_number":"38.2-5200","catch_line":"Definitions","url":"\/38.2-5200\/","token":"38.2\/52\/38.2-5200","metadata":false},{"id":69288,"structure_id":15692,"section_number":"38.2-5201","catch_line":"What laws applicable","url":"\/38.2-5201\/","token":"38.2\/52\/38.2-5201","metadata":false},{"id":60910,"structure_id":15692,"section_number":"38.2-5202","catch_line":"Promulgation of regulations; standards for policy provisions","url":"\/38.2-5202\/","token":"38.2\/52\/38.2-5202","metadata":false},{"id":81626,"structure_id":15692,"section_number":"38.2-5202.1","catch_line":"Refund of premium for cancellation or termination of policy","url":"\/38.2-5202.1\/","token":"38.2\/52\/38.2-5202.1","metadata":false},{"id":63690,"structure_id":15692,"section_number":"38.2-5203","catch_line":"Prohibited provisions","url":"\/38.2-5203\/","token":"38.2\/52\/38.2-5203","metadata":false},{"id":78536,"structure_id":15692,"section_number":"38.2-5204","catch_line":"Preexisting conditions","url":"\/38.2-5204\/","token":"38.2\/52\/38.2-5204","metadata":false},{"id":72116,"structure_id":15692,"section_number":"38.2-5205","catch_line":"Prior institutionalization","url":"\/38.2-5205\/","token":"38.2\/52\/38.2-5205","metadata":false},{"id":60114,"structure_id":15692,"section_number":"38.2-5206","catch_line":"Rates","url":"\/38.2-5206\/","token":"38.2\/52\/38.2-5206","metadata":false},{"id":61118,"structure_id":15692,"section_number":"38.2-5206.1","catch_line":"Rate increases; notice requirements","url":"\/38.2-5206.1\/","token":"38.2\/52\/38.2-5206.1","metadata":false},{"id":78975,"structure_id":15692,"section_number":"38.2-5207","catch_line":"Disclosure","url":"\/38.2-5207\/","token":"38.2\/52\/38.2-5207","metadata":false},{"id":86980,"structure_id":15692,"section_number":"38.2-5207.1","catch_line":"Disclosure; life insurance policies","url":"\/38.2-5207.1\/","token":"38.2\/52\/38.2-5207.1","metadata":false},{"id":66370,"structure_id":15692,"section_number":"38.2-5207.2","catch_line":"Long-term care benefits; monthly report","url":"\/38.2-5207.2\/","token":"38.2\/52\/38.2-5207.2","metadata":false},{"id":61536,"structure_id":15692,"section_number":"38.2-5208","catch_line":"Right to return; free look provision","url":"\/38.2-5208\/","token":"38.2\/52\/38.2-5208","metadata":false},{"id":65391,"structure_id":15692,"section_number":"38.2-5209","catch_line":"Incontestability","url":"\/38.2-5209\/","token":"38.2\/52\/38.2-5209","metadata":false},{"id":74733,"structure_id":15692,"section_number":"38.2-5210","catch_line":"Nonforfeiture benefit","url":"\/38.2-5210\/","token":"38.2\/52\/38.2-5210","metadata":false}],"previous_section":{"id":78536,"structure_id":15692,"section_number":"38.2-5204","catch_line":"Preexisting conditions","url":"\/38.2-5204\/","token":"38.2\/52\/38.2-5204","metadata":false},"next_section":{"id":60114,"structure_id":15692,"section_number":"38.2-5206","catch_line":"Rates","url":"\/38.2-5206\/","token":"38.2\/52\/38.2-5206","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-5205\/","history_text":"

This law was first created in 1987. The record of its establishment is cataloged in chapter 586 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1987 \u201cActs\u201d aren\u2019t available online. It has been modified 1 time. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. That modification is as follows: in 1990, chapter 285.<\/p>","references":false,"refers_to":false,"permalink":{"id":217799,"object_type":"law","relational_id":72116,"identifier":"38.2-5205","token":"38.2\/52\/38.2-5205","url":"\/38.2-5205\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-5205\/","token":"38.2\/52\/38.2-5205","dublin_core":{"Title":"Prior institutionalization","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-5205","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> No long-term care insurance<\/span> policy<\/span> may be delivered or issued for delivery in this Commonwealth if such policy<\/span> conditions eligibility (i) for any benefits provided in an institutional care setting on the receipt of a higher level of institutional care or (ii) for any benefits on a prior hospitalization requirement. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> A long-term care insurance<\/span> policy<\/span> containing any limitations or conditions for eligibility other than those prohibited in subsection A shall clearly label such limitations or conditions, including any required number of days of confinement, in a separate paragraph of the policy<\/span> or certificate<\/span> entitled “Limitations or Conditions on Eligibility for Benefits.” <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> A long-term care insurance<\/span> policy<\/span> 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. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> A long-term care insurance<\/span> policy<\/span> which conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional stay<\/span> of more than thirty days for which benefits are paid. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nPRIOR INSTITUTIONALIZATION (\u00a7 38.2-5205)\n\nA. No long-term care insurance policy may be delivered or issued for delivery in\nthis Commonwealth if such policy conditions eligibility (i) for any benefits\nprovided in an institutional care setting on the receipt of a higher level of\ninstitutional care or (ii) for any benefits on a prior hospitalization\nrequirement.\n\nB. A long-term care insurance policy containing any limitations or conditions\nfor eligibility other than those prohibited in subsection A shall clearly label\nsuch limitations or conditions, including any required number of days of\nconfinement, in a separate paragraph of the policy or certificate entitled\n“Limitations or Conditions on Eligibility for Benefits.”\n\nC. A long-term care insurance policy containing a benefit advertised, marketed\nor offered as a home health care or home care benefit may not condition receipt\nof benefits on a prior institutionalization requirement.\n\nD. A long-term care insurance policy which conditions eligibility of\nnoninstitutional benefits on the prior receipt of institutional care shall not\nrequire a prior institutional stay of more than thirty days for which benefits\nare paid.\n\nHISTORY: 1987, c. 586; 1990, c. 285.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}