Long-Term Care Partnership Program
Overview:
Proposal is authorized by Section 6201(d) of the Deficit Reduction Act (DRA) of 2005.
Type: Private-Public Partnership
Key Components:
- The program allows Medicaid to disregard assets in an amount equal to the insurance benefit payments made under a Partnership-qualified (PQ) LTC insurance policy if and when someone with a PQ plan exhausted their private coverage and applied for Medicaid.
- The DRA enabled the expansion and simplification of an early demonstration program in public-private sector collaboration for insuring LTC. Previously authorized to operate in only four states (CA, CT, NY, and IN), the passage of the DRA allowed any state to establish a Partnership Plan by filing a State Plan Amendment (SPA).
- The simpler rules for the new Partnership plans enabled LTC insurance policies to be designated as “Partnership-qualified” so long as they were purchased with specific types of age-based benefit increase options (inflation-protection) that met the Act’s requirements.
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- All but nine states (and DC) have established Partnership Programs. All states except CA recognize reciprocity, meaning that “spend down” protection will be honored in another state with a Partnership program if someone moves there after buying a Partnership qualified policy in another state.
- Eligibility for Medicaid is not automatic and the services covered under Medicaid may differ from what was included in the PQ private coverage. Medicaid income and other eligibility requirements still apply.
- State partnership programs remain operational, but several states lack dedicated staff due to funding challenges.
- Insurers sell both PQ and non-PQ policies.
Long-Term Care Partnership Program
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