Arizona Health Insurance Practice Exam

In Arizona, long-term care policies may provide benefits based on what criteria?

1. Age-related health conditions

2. The individual's insurance history

3. Ability to perform daily living activities

4. Family medical history

The correct answer is: Ability to perform daily living activities

Long-term care policies are specifically designed to assist individuals who may face challenges with daily activities due to a variety of reasons, often related to age or health conditions. The benefits provided by these policies are primarily based on an individual's functional capability, particularly their ability to perform activities of daily living (ADLs), such as bathing, dressing, eating, toileting, and transferring (moving from one position to another, such as from a bed to a chair). When evaluating eligibility for benefits, insurers look at whether the individual can perform a certain number of these activities independently. This focus on functional ability over other factors, such as age or medical history, underscores the primary goal of long-term care policies: to ensure that individuals receive necessary support when they can no longer care for themselves in certain essential aspects of daily living. While other factors like age-related health conditions or family medical history might influence the need for long-term care, they do not determine the eligibility for policy benefits. The critical measure of eligibility remains the individual’s capacity to perform daily living activities, making this the appropriate and correct basis for benefits in long-term care insurance policies.