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State RegulationsOH specificDifficulty 2/5

A Toledo insured with advanced Alzheimer's disease can still physically perform every activity of daily living but cannot manage medications, finances, or safe navigation at home. Under Ohio long-term care rules, may the insured qualify for benefits?

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Answer & full 3-part explanation (select an option above, or peek)

Why C is correct

OAC 3901-4-01(H)(7) makes cognitive impairment an independent, stand-alone trigger for long-term care benefits alongside limitations in activities of daily living. An insured whose dementia prevents safe, independent functioning may qualify for benefits even though physical ADL performance remains intact, and nothing in Ohio's long-term care framework singles out Alzheimer's disease for exclusion.

Why the other options are wrong

  • A) Physical ADL limitation is one trigger, not the only one; cognitive impairment qualifies on its own.
  • B) Ohio's long-term care rules do not exclude Alzheimer's disease; cognitive impairment is expressly a covered measure of need.
  • D) A prior hospital stay is not a benefit trigger; the 30-day figure Ohio law caps relates to prior institutional stay requirements, not hospitalization.

Memory hook

Cognitive impairment alone can open the LTC benefit door.

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