Long Term Care Insurance Partnership (LTCIP)The Wisconsin Long Term Care Insurance Partnership (LTCIP) Program is a joint effort between the federal Medicaid Program, long- term care insurers, and the state of Wisconsin. But what if a person does not buy an LTCI policy? If she needs long- term care, she must use her income, savings, and assets to pay for it, and if she needs care for a long time, she could exhaust these resources. Then she may have no other recourse than to apply for Medicaid. We have discussed the disadvantages to the individual of this situation, but it also presents a problem for the government - - the more people who rely on Medicaid, the greater the financial burden on this already strained program. States have sought to do this in several ways, including offering tax incentives, targeting education and awareness programs toward consumers and employers, and sponsoring LTCI coverage for state employees and retirees. The New York State Partnership for Long-Term Care combines private long-term care insurance and Medicaid to help New Yorkers prepare for nursing home care or home care. NY Long Term Care and New York Partnership, NY LTC, Long term care and NY LTC Partnership Program. Genworth New York, John Hancock New York, New York Life, Northwestern Mutual. Subject: Long-Term Care Insurance Partnership Program Category: Health > Seniors Asked by: healthresultsgroup-ga List Price: $150.00: Posted: 10:39 PST Expires: 10:39 PST Question ID: 701157. Another approach is long- term care partnership programs, and this is the focus of this chapter and those that follow. A state long- term care partnership program is a program under which a state government modifies its Medicaid eligibility rules give a financial incentive for the purchase of LTC I policies that meet certain requirements, called partnership LTCI policies. The purpose is to increase the number of people covered by private long- term care insurance and so reduce the number who end up relying on Medicaid. Usually, if he needs long- term care the benefits of the policy pay for it and the state Medicaid program does not have to cover the cost. However, in the event that he needs long- term care for such a long time that he uses up the benefits of his LTCI policy and is forced to apply to Medicaid, he is not obligated to spend all the assets he otherwise would. Generally, under what is called the dollar- for- dollar approach, he may keep assets equal in amount to the benefits he received under his partnership policy (in addition to any other assets he would have been entitled to keep). Moreover, these assets are exempt from Medicaid estate recovery and so are preserved for his heirs. She develops a physical impairment and needs Long- term care services. Before she can qualify for Medicaid, she must spend all her assets on care except for $2,0. And when she does receive Medicaid benefits, she must enter a nursing facility instead of staying at home because her state provides only very Limited benefits for home care. Furthermore, the nursing home of her choice does not have any Medicaid beds available, so she must go to a Less desirable facility far from her family. Finally, after she dies any remaining assets are taken by Medicaid under the estate recovery rules. He becomes physically impaired and needs Long- term care services. Instead of spending his savings and assets on care until he has very Little Left in order to qualify for Medicaid, John uses his LTCI benefits to pay for most of his care. This is better for John, as he does not become impoverished, and he does not have to deal with the limitations of Medicaid coverage. But he needs care for several years, and he eventually uses up his policy's $2. He is now forced to apply for Medicaid. NYS Partnership Participating Insurers Offering Individual Policies as of January 2006* Genworth Life Insurance Company of New York. Long-Term Care Partnerships Background. Section 6021 of the DRA expands Long-Term Care (LTC) Partnerships. Summary of the LTC Partnership Program. Section 6021 of the DRA allows for Qualified State LTC Partnerships. LTC, through a partnership with the City of Lowell, is dedicated to providing citizens with gavel- to-gavel coverage of city council meetings and many other government meetings. Partnership for Long Term Care Program; Tax Savings on LTC Policies; Insurers Currently Offering LTC Insurance (PDF). Things to Consider Before Purchasing LTC; Comparing LTC Policies; Optional LTC Benefits; Comparing LTC. About the Long-Term Care Partnership Programs. Long Term Care Partnership Policies allow consumers to keep some of their assets that they would most likely spend down in order to qualify for Medicaid when needing Long Term. New Hampshire Long Term Care Costs & Insurance Quotes. However, because he bought the partnership policy, he does not have to spend all the assets he otherwise would have. In addition to any noncountable assets and the $2,0. Kevin can retain $2. Moreover, this $2. Medicaid estate recovery and preserved for Kevin's heirs. They may be of particular value to those who are unable to afford a large amount of LTCI coverage but have significant assets they want to protect. She cannot afford an LTCI policy with a large lifetime maximum benefit that would cover all her likely long- term care needs, but for a fairly low premium she can buy a partnership policy with a $1. She might not need more than $1. Medicaid, and $1. Ted. In this way partnership policies offer an incentive to those of modest means to buy at least a small amount of LTCI coverage. To mention only two of the most important, if a person exhausts his insurance benefits, it is not guaranteed that he will qualify for Medicaid, and if he does qualify, although some assets are protected, he must generally spend his income on care. These and other disadvantages are discussed in detail later in this course. The Original Partnership Programs . Partnership programs began in 1. Robert Wood Johnson Foundation sponsored demonstration projects in four states, California, Connecticut, Indiana, and New York. These projects received financial grants from the foundation to foster the growth of long- term care insurance in general and to develop partnership programs in particular. The participating states were also granted approval by the U. S. Department of Health and Human Services (HHS) to modify their Medicaid eligibility rules to make such programs possible. But the federal Omnibus Budget Reconciliation Act of 1. OBRA 9. 3) effectively halted the expansion of partnership programs. Under OBRA 9. 3 any new programs would be required to apply estate recovery to protected assets - - that is, an individual with a partnership policy could retain assets as long as he remained living, but those assets would have to be taken by Medicaid after his death and could not be preserved for heirs. However, the Deficit Reduction Act (DRA) of 2. We will examine in detail the DRA and the new partnership programs, but first we will look at the original programs, which have continued to operate. For complete information, the reader should check with each state program. Each state also has various other requirements. Indiana and New York also offer as an alternative the total asset approach, which allows an individual with a partnership policy to keep all his assets, not just an amount equivalent to the LTCI benefits he receives. However, for a person to qualify for total asset protection in these two states, his policy must provide at least a certain amount of benefits. Otherwise, an insured is entitled to Medicaid asset protection only in the state where he bought his policy. One measure of success is how many partnership policies have been sold. This varies widely from state to state, but there are a significant number in all four states, and they represent a substantial percentage of all LTCI policies in force in Connecticut and Indiana. A major factor in the variation among states appears to be the administrative and reporting requirements a state imposes on insurers seeking to participate in the program. If insurers find these requirements too burdensome, many may decide not to market partnership policies, and as a result fewer products are available, fewer agents are selling them, and fewer consumers buy them. Other factors include demographics, agent training, the existence of programs for state employees and retirees, and the non- partnership LTCI products sold in the state. In fact, an extremely small number of those holding partnership policies have exhausted their LTCI benefits and received Medicaid benefits, a fraction of 1 percent of the total. While it is difficult to know how many of these people would have gone on Medicaid if they had not bought a partnership policy, this statistic is nonetheless a strong indication that the existing state programs are meeting their objectives in this regard. At the same time, there has been a desire to learn from the experience of the original states and promote some changes that it is hoped will enhance the success of any new programs. Specifically, the goals have been more simplified administrative procedures, greater uniformity among states in requirements for product design and reporting, less difference in the regulatory treatment of partnership and nonpartnership policies, and reciprocity among state programs. What are the reasons for these goals? This would result in more partnership products available to consumers and a more extensive marketing effort, which should lead to many more people covered by partnership policies. Broad reciprocity thus would make partnership policies much more attractive to consumers, increasing the number of people who buy them. All states may now establish new programs that allow participants to preserve assets after death. This is intended to impose a degree of uniformity across states. Specifically, reciprocity applies unless a state explicitly opts out. However, the degree of uniformity of programs and policies from state to state should facilitate reciprocity. Total asset protection is not permitted. The DRA presents states and the insurance industry with a tremendous opportunity to increase the number of people with LTCI coverage throughout the nation. Establishing State Programs . Programs that meet the DRA requirements are called qualified state long- term care insurance partnership (QSLTCIP) programs. If a state wants to create a QSLTCIP program, it must file a State Plan Amendment (SPA) with the Centers for Medicare and Medicaid Services (CMS), a part of the Department of Health and Human Services. An SPA is the vehicle by which a state seeks federal approval of changes in its Medicaid program. In an SPA establishing a QSLTCIP program, the state sets forth the proposed rules and requirements for its program as well as the date on which the program will become effective. CMS reviews an SPA and either approves it, denies it, or requests modification and resubmission. Idaho was the first state to have its SPA approved, and it formally launched its QSLTCIP program effective November 1, 2. As of mid- 2. 00.
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