State RegulationsOH specificDifficulty 1/5
Under Ohio long-term care rules, what is the most restrictive look-back period a policy may use when defining a "preexisting condition"?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under ORC 3923.44(B)(4) and (B)(5), an Ohio LTC policy may not define "preexisting condition" more restrictively than a condition for which medical advice or treatment was recommended or received from a health-care provider within 6 months preceding the effective date of coverage. Insurers cannot reach further back into the applicant's medical history than that 6-month window.
Why the other options are wrong
- A) A 12-month look-back is more restrictive than Ohio law allows for LTC preexisting-condition definitions.
- B) Five months understates the maximum window insurers are permitted to use.
- D) A 30-day look-back is far narrower than the permitted maximum and misstates the rule.
Memory hook
Pre-x look-back ceiling: 6 months before the effective date — never deeper.