Will you need long-term care and how will you pay for it?

At least 70 percent of people over the age of 65 will need long-term care services at some point during their lives and many will not have a family member who can provide the necessary full-time care.

Who will pay for this care?

Medicare and regular private insurance programs pay very little for the long-term care that most people need whether in a nursing home or in-home care with the activities of daily living (ADLs), such as help with dressing, bathing, and assistance using the bathroom. Medicaid has strict rules pertaining to medical needs, income requirements, and limited assets and require spending down your assets before qualifying.

Long-term care planning

In 2005, the Florida legislature passed a bill that allowed the Long-Term Care Partnership Program to be created. The purpose of this program is to encourage individuals to purchase private long-term care insurance by making insurance available and affordable and by providing long-term incentives. This program is a partnership between Medicaid and private long-term care insurance companies.

Long-Term Care Partnership Policies:

Are tax qualified under federal law, meaning that a portion of the premiums paid may be claimed as a tax deduction.
Provide inflation protection for policyholders.

Most importantly provide dollar-for-dollar asset protection should the policyholder need to apply for long-term Medicaid assistance.

The dollar-for-dollar asset protection means that for every dollar that a policy pays out in benefits, a dollar of personal assets can be protected from the Medicaid spend-down requirement. This means that if you purchase a Partnership-approved private insurance policy with a $40,000 long-term coverage and the insurance company pays the $40,000 limit for your long-term care and you still need long-term care, then you can apply for Medicaid assistance and Medicaid will not count $40,000 of your personal assets when qualifying you for Medicaid. This Medicaid Eligible and Asset Disregard is an important feature of the Partnership program.

Several Long-Term Care policies are offered by various insurance companies. However, there are certain provisions that must be included in order for a policy to be part of Florida’s Long-Term Care Partnership Program.

To qualify a long-term care policy must provide

At least one lower level of care, aside from nursing care. For example home health care and adult day care would be considered a lower level of care than a nursing home.
Lower level of care equal to half of the benefits of nursing care. For example if a policy covers two years of nursing care, they must cover one year of lower level of care.
Coverage to residents of Florida at the time the policy was purchased.

Inflation coverage. Polices issued to those 60 years old or younger shall contain annual compound inflation coverage. Policies for those 61 – 75 years of age shall have compound inflation coverage, and policies for those 76 or older do not need to have inflation coverage.

The State of Florida also has Long Term Care Partnership reciprocity with states that also have reciprocity with Florida. This means that a partnership policy purchased in a qualifying state can be used in Florida.

Horizon Care Services accepts all long-term care insurance.