Illinois Health Insurance Practice Exam

Under a Long-Term Care (LTC) policy, what triggers the benefit payment if the insured is unable to perform specific activities?

1. Driving and Cooking

2. Walking and Reading

3. Bathing and Dressing

4. Exercising and Shopping

The correct answer is: Bathing and Dressing

The correct answer centers on the specific activities of daily living that are commonly used to determine eligibility for benefits under a Long-Term Care (LTC) policy. In the context of LTC insurance, benefit payments are typically triggered when an individual is unable to perform a certain number of these fundamental activities, which are designed to support personal care and maintenance of health. Bathing and dressing represent two of the key activities of daily living that are crucial in assessing an individual's need for long-term care services. If a policyholder is unable to manage these activities independently, it indicates a significant level of impairment, thus prompting the insurance benefits to be activated. The focus of LTC policies is primarily on assisting individuals who are experiencing difficulties with basic self-care tasks that are vital for maintaining dignity and quality of life. In contrast, the other options listed involve various activities that, while potentially important, do not fall under the standard categories of daily living used in these policies. Driving and cooking, walking and reading, as well as exercising and shopping, are not considered essential activities of daily living in the same way that bathing and dressing are. Consequently, they are not typically used as criteria for benefit payment triggers in the context of long-term care insurance.