State RegulationsMA specificDifficulty 1/5
Under 211 CMR 65.05(3), which of the following is a permissible exclusion in a Massachusetts long-term care policy?
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
The exclusions permitted in Massachusetts long-term care policies under 211 CMR 65.05(3) are narrow and conventional — the kind of conduct-based limits found across accident and health coverage, such as intentionally self-inflicted injuries — while the core benefits the product exists to deliver remain covered. Nursing facility care and home care are central long-term care benefits under 211 CMR 65.05, and care for severe cognitive impairment is a fundamental long-term care trigger under 211 CMR 65.05(1), so none of those may be carved out wholesale.
Why the other options are wrong
- A) Severe cognitive impairment is a core long-term care benefit trigger under 211 CMR 65.05(1); dementia-related care is not an excludable category.
- C) Nursing facility care is the archetypal long-term care benefit; a policy excluding it would not deliver the coverage the Massachusetts regulation requires.
- D) Home care is an expressly addressed long-term care benefit under 211 CMR 65.05(2)(c) and cannot be excluded wholesale.
Memory hook
LTC excludes conduct (like self-inflicted injury), not the care the policy exists to cover.