Idaho long term care insurance practice questions
Last updated
Long term care is part of section III of the Idaho specific A&H outline, Idaho statutes, rules and regulations pertinent to health/disability insurance only, which has 10 of the 25 Idaho questions. [1] Idaho's long term care rules come from Idaho Code chapter 46 and the Department's rule IDAPA 18.04.11. Our Idaho health law questions page covers contestability; this page covers the rest, with 10 practice questions.
What policies must and must not do (Idaho Code 41-4605)
- A policy may not be cancelled, nonrenewed or otherwise terminated because of the insured's age or declining mental or physical health. [2]
- It may not cover only skilled nursing care, or give significantly more coverage for skilled care in a facility than for lower levels of care. [2]
- Except for certain employer and union group policies, a preexisting condition may be defined no more strictly than a condition for which medical advice or treatment was recommended or received within six months before coverage starts, and it may be excluded only if the loss begins within six months after coverage starts. [2]
- A policy may not require a prior hospital stay for any benefit. A rider that requires prior institutional care for noninstitutional benefits may not require a stay of more than thirty days. [2]
- Buyers may return the policy within thirty days of delivery for a premium refund. [2]
- An outline of coverage must be given at the initial solicitation; an agent must deliver it before presenting an application. [2]
- The buyer must be offered a nonforfeiture benefit. If it is declined, the insurer must provide a contingent benefit upon lapse after a substantial premium increase. [3]
Benefit triggers and definitions (IDAPA 18.04.11)
Activities of daily living include at least bathing, continence, dressing, eating, toileting and transferring. [4] A policy may not require more than a deficiency in three activities of daily living, or the presence of cognitive impairment, to pay benefits. A deficiency cannot be defined more strictly than needing hands-on assistance from another person, or, for cognitive impairment, needing supervision or verbal cueing. [4] Cognitive impairment means a deficiency in short or long-term memory, orientation as to person, place and time, deductive or abstract reasoning, or judgment as it relates to safety awareness. [4]
Protections against lapse
The applicant may name at least one other person to receive lapse notices, or sign a waiver. A policy cannot lapse for nonpayment unless the insurer gives notice at least thirty days before the lapse, and notice cannot be sent until a premium has been unpaid for thirty days. [4] If the insured was cognitively impaired or lost functional capacity before the grace period ended, coverage can be reinstated if requested within five months after termination. [4]
Selling long term care
- Inflation protection: insurers must offer an option at least as favorable as benefits that increase at a rate compounded annually of at least five percent, or one of the other listed designs. [4]
- Training: a producer must be licensed for life and disability and complete a one-time training of at least eight hours, then at least four hours every twenty four months. Training completed in any state satisfies Idaho. [4]
- Suitability: the producer and issuer consider the applicant's ability to pay, goals and needs, and existing coverage, using a Long-Term Care Insurance Personal Worksheet given at or before application. [4]
- Banned practices: twisting, high pressure tactics, cold lead advertising and misrepresentation. [4]
Practice questions
1. Can an Idaho long term care policy be cancelled because the insured's health declines?
A. Yes, at renewal
B. Yes, after age 85
C. No
D. Only for a group policy
Answer: C. (Idaho Code 41-4605(2)(a)) [2]
2. How long is the free look on a long term care policy?
Answer: Thirty days from delivery. (41-4605(6)) [2]
3. A policy limits preexisting conditions. What is the strictest look-back allowed on an individual policy?
Answer: Six months before the effective date of coverage. (41-4605(3)(a)) [2]
4. Can a long term care policy require a hospital stay before paying benefits?
Answer: No. (41-4605(4)(a)(i)) [2]
5. When must an agent deliver the outline of coverage?
Answer: Before presenting an application or enrollment form. (41-4605(7)(a)(ii)) [2]
6. Which is one of the six activities of daily living Idaho requires policies to recognize?
Answer: Bathing, continence, dressing, eating, toileting or transferring. (IDAPA 18.04.11.033.02) [4]
7. What is the most a policy may require before paying benefits?
Answer: A deficiency in three activities of daily living, or the presence of cognitive impairment. (IDAPA 18.04.11.033.01) [4]
8. A premium is due and unpaid. When is the earliest the lapse notice may be sent?
Answer: Thirty days after the premium is due and unpaid, and the lapse cannot take effect until at least thirty days after notice. (IDAPA 18.04.11.013.01.c) [4]
9. A policy lapsed while the insured had dementia. How long does the insured have to request reinstatement?
Answer: Five months after termination. (IDAPA 18.04.11.013.02) [4]
10. How much training must a producer complete before selling long term care?
Answer: A one-time training of at least eight hours, then at least four hours every twenty four months. (IDAPA 18.04.11.027.04.a) [4]
Study tips
- Thirty is the key number: thirty day free look, thirty day lapse notice timing, thirty day limit on prior institutional stays.
- Six months shows up twice in the preexisting rule: six months back and six months forward.
- Benefit triggers: three of six ADLs, or cognitive impairment.
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Sources
Laws and exam documents quoted as of October 2026.
- Pearson VUE, Idaho content outlines 121301 (effective July 31, 2025): https://www.pearsonvue.com/content/dam/VUE/vue/en/documents/publications/121301.pdf
- Idaho Code 41-4605: https://legislature.idaho.gov/statutesrules/idstat/Title41/T41CH46/SECT41-4605/
- Idaho Code 41-4607: https://legislature.idaho.gov/statutesrules/idstat/Title41/T41CH46/SECT41-4607/
- IDAPA 18.04.11: https://adminrules.idaho.gov/rules/current/18/180411.pdf