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Long Term Care Insurance

Long Term Care Insurance

Long Term Care (LTC) Insurance provides coverage for individuals aged 65 or older or individuals who require constant supervision due to a chronic or disabling condition.  LTC Insurance can be purchased to pay for the costs associated with nursing home care, home health care, and personal or adult day care up to the policy limits.

Although, Medicaid may offer some coverage for costs associated with long-term care, qualification is based on the individual’s assets.  Medicare does not pay for most long-term care.

Adult Day Care

Adult day care typically provides day-time programs for adults who need supervision when their caregivers are not available.

Assisted Living

Assisted living is a housing facility for people with disabilities or for adults who cannot live independently.

Home Health Care

Home health care can include skilled nursing care, as well as other skilled care services, like physical and occupational therapy, speech language therapy, and medical social services.  These services often are provided by a variety of skilled health care professionals at home.

Skilled Nursing Facility

A skilled nursing facility is an in-patient rehabilitation and medical treatment center staffed with trained medical professionals.  They provide the medically necessary services of licensed nurses, physical and occupational therapists, speech pathologists, and audiologists.

Long Term Care Insurance Rate Increases

Insurance companies that sell LTC Insurance in Idaho are required to report a policy premium rate increase to the Department of Insurance prior to notifying their policyholders.

Insurance companies must justify the premium rate increase in their report to the Department of Insurance.  However, if the company is able to show that the required criteria has been met for the rate increase, the Department of Insurance has little authority to disallow the premium increase.

Long Term Care Partnership Program

The Idaho Long Term Care Partnership Program is a program in which state government and private insurers have partnered to encourage Idahoans to prepare for their future care needs by purchasing insurance that will help pay for the costs associated with required care at a long-term care facility like a nursing home.

Under this program, when the state is making a determination of an individual’s eligibility for Medicaid assistance for costs associated with long-term care, the individual’s personal assets equal to amounts paid under a qualifying insurance policy will be disregarded.

For example, if a qualifying insurance policy pays $50,000 in benefits to cover the policyholder’s long-term care needs, Medicaid will disregard up to $50,000 of that individual’s assets when making a determination on whether the individual is eligible for Medicaid assistance for their long-term care costs.  This means the individual may qualify for long-term care assistance through Medicaid without first having to spend all of their personal assets on care.

Only certain types of LTC Insurance policies qualify for the Partnership Program.  The state and federal laws governing the program are subject to change.  If you are considering purchasing LTC Insurance, talk to your insurance agent about whether an eligible LTC Insurance policy is appropriate for your needs.

Have more questions?

Contact the Consumer Affairs team:

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