HRS §431:10H-109
Rules for long-term care insurance prior care requirements
This section bans long-term care insurance policies in Hawaii from requiring a hospital stay or nursing home stay before paying benefits, except in limited cases. If a policy has such requirements, they must be clearly labeled. Any required nursing home stay before home care cannot be longer than 30 days.
The statute, as written — Prior hospitalization; prior institutionalization
(a) No long-term care insurance policy may be delivered or issued for delivery in this State if the policy: (1) Conditions eligibility for any benefits on a prior hospitalization requirement; (2) Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or (3) Conditions eligibility for any benefits other than waiver of premium, post-confinement, post-acute care, or recuperative benefits on a prior institutionalization requirement. (b) A long-term care insurance policy containing post-confinement, post-acute care, or recuperative benefits 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. (c) A long-term care insurance policy that conditions eligibility of non-institutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than thirty days.
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