State RegulationsOH specificDifficulty 3/5
An insured in Akron was receiving nursing facility benefits, was discharged, and is readmitted shortly afterward. Under Ohio long-term care rules, which statement is correct?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
ORC 3923.44 and OAC 3901-4-01 work as a pair of protections: a policy providing benefits only after institutionalization may not require a prior stay of more than 30 days, and it may not condition benefits on readmission within less than 30 days after discharge. Insureds therefore cannot be penalized under Ohio law merely because they returned to care quickly. The Ohio Department of Insurance treats both limits as mandatory policy-design rules.
Why the other options are wrong
- A) 60 days is not an Ohio readmission barrier; the rule actually protects readmissions occurring within 30 days.
- C) Ohio law prohibits conditioning readmission benefits on a repeated qualifying period; readmission does not automatically restart a prior-stay requirement.
- D) There is no minimum time-at-home requirement of 6 months for readmission benefits under Ohio LTC rules.
Memory hook
Quick return, no penalty: within 30 days of discharge, benefits can't be barred.