Long-term care policies may require all of the following before paying benefits EXCEPT:

Long-term care policies generally have specific requirements that must be met before benefits can be paid. In this context, stating that a prior hospitalization is not a requirement for benefits emphasizes an important aspect of long-term care insurance. Unlike some health insurance policies that may necessitate hospitalization for certain coverage, long-term care insurance is designed to provide support for individuals who may require assistance with daily living activities due to chronic illness, disability, or age-related issues, regardless of whether they have been hospitalized.

In contrast, a physician's certification of need is commonly required, as this ensures that there is a legitimate medical necessity for the care being requested. A functional assessment is also typically part of the process, as it objectively evaluates an individual's ability to perform daily activities and determines the level of care required. Additionally, an elimination period is a standard provision which imposes a waiting period before benefits begin, allowing insurers to manage claims and costs effectively.

Thus, while hospitalization can be important in acute care contexts, it is not a prerequisite for long-term care benefits, making it the correct answer in this scenario.