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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>72116</law_id><section_number>38.2-5205</section_number><catch_line>Prior institutionalization</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="52">Long-Term Care Insurance</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> No <span class="dictionary">long-term care insurance</span> <span class="dictionary">policy</span> may be delivered or issued for delivery in this Commonwealth if such <span class="dictionary">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. <a id="paragraph-259847" class="section-permalink" href="https://vacode.org/38.2-5205/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> A <span class="dictionary">long-term care insurance</span> <span class="dictionary">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 <span class="dictionary">policy</span> or <span class="dictionary">certificate</span> entitled &#x201C;Limitations or Conditions on Eligibility for Benefits.&#x201D; <a id="paragraph-259848" class="section-permalink" href="https://vacode.org/38.2-5205/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> A <span class="dictionary">long-term care insurance</span> <span class="dictionary">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. <a id="paragraph-259849" class="section-permalink" href="https://vacode.org/38.2-5205/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> A <span class="dictionary">long-term care insurance</span> <span class="dictionary">policy</span> which conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional <span class="dictionary">stay</span> of more than thirty days for which benefits are paid. <a id="paragraph-259850" class="section-permalink" href="https://vacode.org/38.2-5205/#D"><i class="fa fa-link"/></a></p></section></text><history>1987, c. 586; 1990, c. 285.</history><metadata></metadata></law>
