                                 CODE OF VIRGINIA

PRIOR INSTITUTIONALIZATION (§ 38.2-5205)

A. 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.

B. 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
&#8220;Limitations or Conditions on Eligibility for Benefits.&#8221;

C. 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.

D. 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.

HISTORY: 1987, c. 586; 1990, c. 285.