NAC687B.111. Coverage for preexisting conditions.

     1. A long-term care insurance contract or certificate, other than a long-term care insurance contract or certificate issued to a group described in subsection 1 of NAC 687B.025, may not:

     (a) Define “preexisting condition” in a more restrictive manner than as a condition for which medical advice or treatment was recommended by, or received from a provider of health care within the 6 months preceding the effective date of coverage of the insured.

     (b) Exclude coverage for a loss or confinement which is the result of a preexisting condition unless the loss or confinement begins within the 6 months following the effective date of coverage of the insured.

     2. An insurer may use an application form designed to elicit the complete medical history of an applicant, and, on the basis of the answers on that application, underwrite a long-term care insurance contract in accordance with that insurer’s established underwriting standards. Unless otherwise provided in the long-term care insurance contract or certificate, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in paragraph (b) of subsection 1 expires. A long-term care insurance contract or certificate may not exclude or use waivers or riders of any kind to exclude, limit or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period described in that paragraph.

     (Added to NAC by Comm’r of Insurance, eff. 11-21-88; A by R028-10, 12-16-2010, eff. 10-1-2011)