What is a long-term care partnership policy?
A partnership policy makes it easier to qualify for Medicaid if you have exhausted the benefits of your long-term care insurance policy. For example, a consumer with a $200,000 coverage limit on his long-term care policy might exhaust the benefits after three years in a nursing home. If that consumer needs continued care, he may need to turn to Medicaid.
What benefits must be included in a partnership policy?
A partnership policy has three basic requirements:
- The policy must have the same provisions as the National Association of Insurance Commissioners (NAIC) model law. Since 2004, all plans sold in Missouri must comply with the model and be approved by the Department of Insurance, Financial Institutions & Professional Registration (DIFP) before they can be sold to consumers.
- The policy must be tax-qualified. This means the IRS does not tax the policy’s benefits.
- The policy must contain certain inflation protection provisions at the time it is sold:
|| Compound annual inflation protection
|Less than 61
||Company must offer 5 percent. If rejected by the consumer, a minimum of 3 percent or changes based on the consumer price index must apply.
|61 – 75
||Some level of inflation protection must apply. No minimum level is established.
||No inflation protection required for partnership policies.
How does a long-term care partnership policy work?
States are required to develop partnerships using the “dollar for dollar” model. For every dollar that a long-term care partnership insurance policy pays out in benefits, a dollar of personal assets can be protected if you apply for Medicaid. In other words, if your long-term care partnership policy paid out $200,000 for your long-term care, an additional $200,000 of your assets would be disregarded when determining your Medicaid eligibility.
What are the Medicaid eligibility requirements ?
- Medicaid eligibility is complex and is determined on a case by case basis.
- Medicare eligibility determinations are completed by the applicant's local department of social services office.
- Medicaid eligibility has both financial and non-financial requirements. Financial requirements include evaluation of both income and assets. Non-financial requirements include proof of Missouri residency, citizenship and identity, Social Security Number and proof of a required level of care for long-term care services.
- Medicaid eligibility has special rules for married people when only one is receiving long-term care services.
- Medicaid eligibility has special rules that apply to home property in which the applicant resides, vehicles and burial arrangements.
If you have any more questions about Medicaid eligibility, please contact MO HealthNet Division.
What if I already have a long-term care policy?
If your current policy fits the three basic requirements above and you purchased it before Feb. 8, 2006, call your insurance agent or company and ask that it be designated a partnership policy. If your current policy does not meet the three basic requirements, federal law will not allow it to be "grandfathered." You may need to buy additional coverage for that designation.
How do I know if I have a partnership policy?
This information will be included with the policy, but may not be printed on the policy itself. If there is any doubt, ask your insurance agent or call the insurance company.
Which insurance companies offer partnership policies?
At this link, you'll find a list of insurance companies selling partnership policies in Missouri. Every insurance company authorized to sell health insurance in Missouri is eligible to sell partnership policies, but the policies must be approved by the Department of Insurance, Financial Institutions & Professional Registration.
Will my Missouri partnership policy qualify me for dollar-for-dollar asset protection in other states?
Yes. Missouri participates in a national reciprocity agreement, but not all states participate. You will also need to meet all Medicaid requirements of the new state of residence.Click here for a map showing all of the states that participate in a national reciprocity agreement.
When should partnership policyholders apply for Medicaid?
- When the partnership policyholder exhausts the benefits of the long-term care partnership policy (policy exhaustion is not required in Missouri).
- When the partnership policyholder (or spouse, family or friend) feels that the individual is having a difficult time paying for care. Everyone has the right to apply for Medicaid at any time.
If I exhaust my long-term care partnership policy, will I automatically qualify for Medicaid?
No. You must still meet the level of care, income and resource requirements for long-term care.
What makes Missouri's partnership program unique?
- It allows conversion of policies that already meet the partnership criteria.
- Inflation protection will be a base 3 percent annual compound level, but it could be based on the Consumer Price Index.
- Insurance agents must take an eight-hour training course before selling partnership policies. Agents will also need to take a four-hour continuing education course every other year.
Where can I buy a partnership policy?
Click here to view a list of long-term care insurers selling these Medicaid-approved policies in Missouri.
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