State RegulationsMA specificDifficulty 2/5
A Massachusetts long-term care policy applicant asks whether care received at home from a home health agency can count as a long-term care benefit. What is correct under Massachusetts' long-term care regulation?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Massachusetts' long-term care benefit standards expressly reach home health care: 211 CMR 65.05(2)(c) addresses home health care within the benefit provisions, and related benefit standards appear at 211 CMR 65.06(3), both under the Massachusetts Division of Insurance's long-term care regulation 211 CMR 65.00. Long-term care coverage is not confined to institutional nursing facility care, so a properly designed policy can pay benefits for qualifying care delivered in the insured's own home.
Why the other options are wrong
- A) Massachusetts long-term care benefit standards are not limited to nursing facility care; home health care is expressly addressed at 211 CMR 65.05(2)(c).
- B) No hospital-confinement prerequisite gates home care benefits under the Massachusetts long-term care regulation.
- C) The availability of family assistance is not a coverage condition imposed by 211 CMR 65.05(2)(c) for home health care benefits.
Memory hook
LTC is care wherever it happens — including at home — under 211 CMR 65.05.