3.2 Nevada Disability and Long-Term Care Insurance

Nevada regulates disability income, long-term care (LTC), and Medicare Supplement insurance under Title 57 NRS, principally Chapters 689A (individual health) and 689B (group/related provisions), alongside federal standards.

Disability Income Insurance

Disability income policies replace a portion of earnings when illness or injury prevents work. Nevada requires standard health-policy provisions:

Key rating/benefit concepts tested with disability income include the elimination (waiting) period, the benefit period, and the definition of disability (own-occupation vs. any-occupation, and total/partial/residual/recurrent disability).

Exam Tip: Notice of claim is typically 20 days; proof of loss is typically 90 days. The exam contrasts these two timeframes.

Long-Term Care Insurance

LTC insurance covers custodial and skilled care (nursing home, assisted living, home care) that medical insurance and Medicare largely do not. Nevada imposes strong consumer protections.

LTC Partnership Program

Nevada participates in the Long-Term Care Partnership Program. A consumer who buys a Partnership-qualified LTC policy earns Medicaid asset disregard equal to the benefits the policy pays: if the policy pays $200,000 of care, the insured may keep an additional $200,000 in assets and still qualify for Medicaid once benefits are exhausted. This is the program's central exam point.

LTC Producer Training

A producer must complete an 8-hour initial LTC course before the first sale and a 4-hour ongoing course each triennial renewal (the ongoing hours count toward the 30-hour CE total).

Exam Tip: LTC's 30-day free look and the Partnership Medicaid asset protection are the two most-tested LTC items in Nevada.

Medicare Supplement (Medigap)

Nevada regulates standardized Medigap plans, which fill gaps in Original Medicare (Parts A and B). Plans are lettered and standardized federally; carriers choose which to offer.

Open Enrollment

Nevada Birthday Rule

Nevada is one of a handful of states with a birthday rule: each year, current Medigap policyholders get a guaranteed-issue window to switch to a plan with equal or lesser benefits without health underwriting.

Important: Producers should proactively tell Medigap clients about the birthday rule — it is a valuable annual chance to re-shop pricing without medical underwriting. (Confirm the current window length, which Nevada has expanded over time.)

How LTC Benefits Are Triggered

A tax-qualified LTC policy pays benefits when a licensed health professional certifies the insured cannot perform a set number of Activities of Daily Living (ADLs) — bathing, dressing, transferring, toileting, continence, and eating — usually two of six, or has a severe cognitive impairment (such as Alzheimer's disease) requiring supervision. After the elimination period (a deductible measured in days), the policy pays the daily or monthly benefit for covered care in a nursing home, assisted-living facility, or the insured's home.

Medicare, Medicaid, and the LTC Gap

LTC exists because the major government programs do not cover extended custodial care. Medicare pays only limited, skilled, post-hospital care (up to 100 days, with cost sharing after day 20) — not ongoing custodial care. Medicaid covers long-term custodial care but only after the individual spends down to strict asset limits. This gap is why the Partnership Program matters: it lets a buyer protect assets equal to the benefits the Partnership policy pays and still qualify for Medicaid afterward.

Medicare Basics for Producers

Producers selling Medigap should know the four parts of Medicare: Part A (hospital), Part B (medical/outpatient), Part C (Medicare Advantage, a private alternative), and Part D (prescription drugs). Medigap supplements Original Medicare (A and B) and cannot be sold alongside a Medicare Advantage plan — selling a Medigap policy to someone enrolled in Medicare Advantage (where it would duplicate coverage) is an unfair practice.

Exam Tip: It is illegal to sell a Medigap policy that duplicates coverage the applicant already has, including to a Medicare Advantage enrollee. Confirm what the client already has before recommending a supplement.