State RegulationsMI specificDifficulty 2/5
A retired teacher in Grand Rapids needs ongoing help bathing and dressing after a stroke, but she needs no skilled nursing services. Her Michigan long-term care policy pays benefits when the insured needs assistance with activities of daily living. What level of care is she receiving?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Because the help she needs is personal assistance with activities of daily living rather than treatment by medical professionals, she is receiving custodial care. Michigan long-term care policies regulated under the Insurance Code of 1956 (M.C.L. 500.3901 to 500.3955) are designed to pay benefits for precisely this situation, where the trigger is the insured's inability to perform daily activities rather than the delivery of skilled medicine.
Why the other options are wrong
- A) Prior physician treatment of the stroke does not convert everyday personal assistance into skilled nursing care.
- B) The scenario describes home-based personal assistance, not hospital confinement or intensive care.
- D) Custodial care is a recognized, fundamental level of care in long-term care insurance even though no medical service is being delivered.
Memory hook
ADL help with no medical skills = custodial, the everyday core of LTC coverage.