Medicare (Parts A through D and the 2026 figures), Medigap plan letters and federal Medigap enrollment rights, Medicaid, and long-term care basics are the same nationwide and are covered in the national Senior and Special Needs guide. Kansas's tested state material for this topic is long-term care insurance. It is governed by K.S.A. 40-2227 and 40-2228 and the LTC regulations at K.A.R. 40-4-37 through 40-4-37v. This guide covers those rules.

What counts as LTC insurance

Long-term care insurance covers diagnostic, preventive, therapeutic, rehabilitative, maintenance, custodial or personal care services provided in a setting other than an acute care unit of a hospital (K.S.A. 40-2227(a)).

Policy requirements

Renewability.

• An individual LTC policy must be at least guaranteed renewable for life (K.A.R. 40-4-37a).
• A policy may not be cancelled, nonrenewed or terminated solely because of the insured's age or deteriorating mental or physical health (K.S.A. 40-2228(d)).

Benefit restrictions an LTC policy may not impose:

• It may not exclude or limit benefits for Alzheimer's disease or other organic brain disease, including senile dementia (K.A.R. 40-4-37(c)).
• It may not require prior hospitalization or institutionalization before paying benefits (K.S.A. 40-2228(f)).
• It may not cover only skilled nursing care, or give significantly more coverage for skilled care than for lower levels of care (K.A.R. 40-4-37e(c)).
• It may not define a preexisting condition more restrictively than one for which advice or treatment was recommended or received within six months before coverage began (K.S.A. 40-2228(e)).
• It may not impose more than one elimination period for confinements from the same or related causes that are separated by less than six months (K.A.R. 40-4-37e).

Required features:

• Home care. If a policy covers home health or community care, the total home care coverage must equal at least one-half of one year's nursing home benefit (K.A.R. 40-4-37n).
• Confinement at termination. If the policy ends while the insured is confined in a nursing facility (other than through lapse), benefits for that stay continue until the earliest of discharge, the end of the benefit period, or payment of the maximum benefit (K.A.R. 40-4-37c).
• Disabled children. Family coverage continues for a child past the limiting age if the child can't support himself or herself because of a disability and is chiefly dependent on the insured (K.A.R. 40-4-37c).
• Inflation protection. The insurer must offer protection at least as favorable as 5% compounded annually. It is included unless the buyer signs a rejection, which becomes part of the application (K.A.R. 40-4-37o).
• Loss ratio. In aggregate, individual policies must return at least 60% of earned premium as benefits, and group policies at least 65% (K.A.R. 40-4-37k).

Sales and delivery

• Outline of coverage. An agent delivers it at the time of application. A direct-response insurer delivers it on request and no later than policy delivery (K.S.A. 40-2228(g)).
• Replacement question. The application asks about other health coverage in force and whether the new policy will replace any accident and sickness policy (K.A.R. 40-4-37i).
• Face of the policy. The words "This is a limited policy read it carefully" must appear in at least 18-point bold type (K.A.R. 40-4-37f(a)).
• Free look. The owner may return the policy within 30 days of delivery for a premium refund. The refund is paid within 10 business days after the insurer or agent receives the returned policy (K.A.R. 40-4-37f(b)).
• Partnership training. An agent selling LTC Partnership policies completes four hours of initial certified partnership training, then at least one hour each biennium. Approved hours may also count toward CE (K.A.R. 40-4-37v).

Life policies with LTC-type benefits

A life policy with an accelerated benefit rider for chronic illness or confinement may not be marketed as long-term care insurance (K.A.R. 40-2-20(u)). Accelerated benefit rules are covered in the Kansas life policy provisions guide.

Common exam traps

• LTC must be at least guaranteed renewable for life, and it can't be dropped for age or declining health.
• An LTC policy can't require a prior hospital stay and can't exclude Alzheimer's.
• The preexisting condition look-back is six months.
• The LTC free look is 30 days, with the refund due in 10 business days. The life insurance free look is only 10 days.
• Inflation protection is 5% compound unless rejected in writing.
• Partnership training is 4 hours initially, then 1 hour per biennium.