Senior Resource Directory Senior Resource Directory

FINANCIAL SERVICES
Planning for Long Term
Care Needs
The California Partnership for
Long Term Care is another insurance
option avail able to a person
who is plan ning for their long term
care needs. This dem on stra tion
project is a part ner ship between
the state of California, the private
in sur ance companies, and the
consumer.
The purpose of the California
Part ner ship is to 1) offer af ford able
LTC insurance to moderate and
middle income consumers; 2) by
example and consumer education
improve the quality of long-
term care insurance; 3) reduce
the government ex pen di tures for
long-term care expenses by providing
an incentive for in di vid u als to
pur chase policies. This is the Medi-
Cal asset protection equal to the
dollar value of insurance benefi ts
re ceived.
All long-term care policies marketed
in California must meet certain
consumer standards established
by state law. The California Partner
ship policies have additional
standards that must be met to
be marketed under the partnership
plan. All Partnership policies
must use the same set of criteria to
determine eligibility for benefi ts.
There is a min i mum daily benefi t
guar an teed to provide mean ing ful
coverage. Au to mat ic infl ation protection
is man da to ry. In de pen dent
care management agen cies must
provide assessment and care plans
for consumer. There are limitations
on future rate increases,
and an option that allows you to
“step down” your coverage if your
fi nancial sit u a tion changes making
it im pos si ble to pay the current
premium. You may designate
another person to be notifi ed if
you fail to pay premiums within
30 days of the due date. One dollar
of your assets will be protected for
every dollar a Part ner ship policy
pays out in benefi ts in the event
that you will later need to apply for
Medi-Cal benefi ts to continue paying
for your long-term care.
You must be a California resident
when you purchase a Partnership
approved LTCI policy, but
you may use the benefi ts outside
of Cal i for nia. When and if you
would need to apply for Med ic aid
(Medi-Cal in California) and take
advantage of the asset protection,
you would need to be a California
resident to protect your assets under
this contract.
Insurers are required to document
the long-term care benefi ts that
have been paid on your behalf and
to verify the amount of assets that
have been protected. A report is
sent quarterly to the policyholder
showing what benefi ts apply to the
asset pro tec tion.
When there is a couple and one
spouse must go into a nursing
home and the other spouse remains
in the community, the commu
ni ty spouse may retain a certain
amount of assets ($95,100 in 2005)
and a certain amount of monthly
income ($2,378 in 2005) without
affecting the eligibility for Medi-
Cal of the nursing home spouse.
When the nursing home spouse
has a Part ner ship LTCI policy,
he/she may main tain ad di tion al
protected assets equal to the qualifi
ed benefi ts that have been paid
by the Part ner ship policy. This is
in ad di tion to the assets allowed to
the com mu ni ty spouse.
Policies may be purchased to cover
only the amount of assets that
need to be protected. The minimum
coverage would cover assets
to equal the cost of one year in a
nursing home, $65,000 in 2005.
Cov er age may be for 1,2,3,4,5 years
or lifetime.
Two types of policies are offered
by the Partnership. Nursing Home
and Assisted Living will cover care
32 2005-2007 SANTA BARBARA COUNTY SENIOR RESOURCE DIRECTORY
in a nursing home or a residential
care facility. The second type
of policy is the Comprehensive
plan which covers nursing home,
residential care facility, and home
care benefi ts in the pol i cy hold er’s
home.
Evaluating and planning for your
long term care needs is very complex
and is something that each individual
should take enough time
to un der stand the many options
that are available. The California
Partnership for long term care
insurance is only one option that a
person may wish to consider.
If you cannot afford to pay for
long-term care insurance, or if
the person who needs insurance
already has a diagnosis which will
lead to a denial of the ap pli ca tion,
consult with an attorney experienced
in Medi-Cal long-term care
planning.
If you have further questions about
assessing your needs for long term
care insurance and other methods
of plan ning for these needs, you
may contact the Health Insurance
Coun sel ing and Advocacy
Program (HICAP) to meet with a
HICAP counselor to discuss your
individual ques tions. This is a free
service and counseling is done by
trained, reg is tered HICAP volunteer
counselors. Call 800-434-0222
for an ap point ment.
Credit Counseling
Consumer Credit Counseling
Services
5276 Hollister Avenue
Santa Barbara, CA 93111
800-540-2227
Consumer Credit Counseling
Service is a non profit agency that
counsels and educates consumers
about debt, credit, budgeting,
and housing matters including
reverse mortgages. Main tains
con fi den ti al i ty of clients and
counseling sessions are free. Three
counseling sites in Santa Barbara