California Partnership for Long Term Care

Frequently Asked Questions

The California Partnership for Long-Term CareCare given to someone who can no longer perform activities of daily living.
The California Partnership for Long-Term Care (Partnership) is dedicated to educating Californians on the need to plan ahead for their future long-term care and to consider private insurance as a vehicle to fund to that care. The Partnership is an innovative program of the state of California in cooperation with a select number of private insurance companies. These companies have agreed to offer high quality policies that meet stringent requirements set by the Partnership and the state. These special policies are commonly called “Partnership Policies.”

What are the chances I’ll need long-term care?

Unfortunately, everyone is at risk of needing long-term careCare given to someone who can no longer perform activities of daily living.. At least 70 percent of people over age 65 will require some long-term care services at some point in their lives, according to the U.S. Department of Health and Human Services. Your personal risk of needing long-term care depends on many factors, such as longevity, gender, marital status and health history.

I don’t live in California. Can I still buy a Partnership policy?

A person must be a California resident to buy a California Partnership-certified long-term careCare given to someone who can no longer perform activities of daily living. policy. The only policy feature that is not recognized outside of California is the unique Medi-Cal asset protection.

Should I replace my existing policy with a newer one?

The advantage of replacing an older policy is that newer policies may offer benefits that are more desirable and feature fewer restrictions. However, just because a policy is newer does not necessarily mean it is better than the one you have. One disadvantage to replacement is that the insurance company will charge higher premiums because you are older than you were when you bought your original policy.

Will my health insurance cover long-term care costs?

Health insurance covers hospital, doctor and prescription expenses related to illness or injury. Only private, long-term care insuranceSpecific type of insurance policy designed to offer financial support to pay for necessary long-term care services. coverage will pay for services such as assistance with daily activities.

How does Asset Protection work?

Medi-Cal asset protection is available only in Partnership policies. To qualify for Medi-Cal to cover the costs of long-term careCare given to someone who can no longer perform activities of daily living., individuals must spend down virtually all of their savings, CDs, investments, etc., to $2,000. They are allowed to keep their house and one car. Individuals who have purchased a Partnership policy, however, will be able to retain assets equal to the amount their private insurance paid for their long-term care.

Can I afford long-term care insurance?

Most people should not spend more than 7 percent of their total annual income on annual premiums for a long-term care insuranceSpecific type of insurance policy designed to offer financial support to pay for necessary long-term care services. policy. Remember that after retirement, income often does not keep pace with inflation. When talking to an agent about long-term careCare given to someone who can no longer perform activities of daily living. insurance, it is important for you and your agent to understand your financial circumstances so that he or she can tailor a plan best suited to your needs.

What special consumer protection provisions are included in Partnership-certified policies?

Partnership-certified policies include automatic built-in inflation protectionProtects the policyholder from covering the difference between what the insurance policy will pay, which is based on the costs of services when you purchased the policy, and the actual cost of care when you need it. Every Partnership policy is required to have this protection, and the state highly recommends that you protect yourself by only purchasing a policy with inflation protection.; care coordination; minimum levels of benefits; monthly home- and community-based careAdult day care or adult day health care or Alzheimer's day care benefits; special agent training requirements; waiver of premiumsWhile in benefit in a nursing home or residential care facility many policies allow the policyholder to stop paying premiums. A premium waiver may only apply when using the nursing facility benefit or other institutional benefit, although some policies may waive premiums while using the home care or other benefits of the policy. provision; elimination periodAn elimination, deductible or waiting period is the number of days one must wait after the company certifies eligibility for benefits but before the policy begins paying for care. Some policies have no elimination period and pay benefits from the first day. The most common waiting periods available are 30, 60 or 90 days. The policyholder is personally responsible for the costs of long-term care expenses during the elimination period. The policy premium will be lower if a longer elimination period is selected, but the policyholder will pay the full cost of care during that time. It is recommend that it be no more than 30 days on policies of less than two years and no more than 90 days on other policies.; prior reviews of the policy’s premiums; and Medi-Cal asset protection.

What is long-term care insurance?

High quality long-term care insuranceSpecific type of insurance policy designed to offer financial support to pay for necessary long-term care services. will pay the majority of costs for a nursing facility or residential care facility. A high quality policy that includes coverage for care at home will provide a meaningful amount of money to help pay for long-term careCare given to someone who can no longer perform activities of daily living. services to supplement the care provided by friends or family.

What is the California Partnership for Long-Term Care?

Established in 1994, the California Partnership for Long-Term CareCare given to someone who can no longer perform activities of daily living. is a program of the California Department of Health Care Services. The Partnership is dedicated to protecting the welfare of Californians against the potentially devastating emotional and financial costs associated with paying for long-term care. The program’s goals include:

 

  1. educating consumers about the risks and costs of long-term care and available financing options
  2. improving the quality and availability of long-term care insuranceSpecific type of insurance policy designed to offer financial support to pay for necessary long-term care services. policies available to Californians
  3. offering Californians affordable, quality insurance protection
How much do Partnership policies cost?

Partnership policies cost approximately the same as other policies that offer similar coverage. But Partnership policies include lifetime asset protection against the high costs of long-term careCare given to someone who can no longer perform activities of daily living. and provide access to Medi-Cal services should you ever need them.

What is long-term care?

Long-term careCare given to someone who can no longer perform activities of daily living. is the assistance provided to people with a chronic illness or disability, whose physical or mental conditions prevent them from carrying out activities of daily living, such as bathing, eating and dressing.

What is unique about the Partnership policies?

Partnership-certified policies include high quality insurance benefits to help pay for the care you may need and automatic inflation protectionProtects the policyholder from covering the difference between what the insurance policy will pay, which is based on the costs of services when you purchased the policy, and the actual cost of care when you need it. Every Partnership policy is required to have this protection, and the state highly recommends that you protect yourself by only purchasing a policy with inflation protection. to ensure that the benefits keep pace with the rising cost of care. Partnership policies also include a unique state-guaranteed asset protection feature that protects you against impoverishment due to the costs of long-term careCare given to someone who can no longer perform activities of daily living., even if you use up all the benefits of your policy.

What does the Partnership do?

The Partnership educates Californians about the risks and costs of long-term careCare given to someone who can no longer perform activities of daily living.. It is anticipated that this heightened awareness will result in the purchase of long-term care insuranceSpecific type of insurance policy designed to offer financial support to pay for necessary long-term care services., thereby reducing the number of people becoming impoverished as a result of spending down their assets to qualify for Medi-Cal. More importantly, long-term care insurance allows individuals to maintain control of their lives and finances and to choose how and where they receive their long-term care.

How does the care management provision work?

The Partnership’s care managementA process to assess, plan, coordinate and monitor long-term care needs and services. Care management/care coordination takes an all-inclusive look at a person’s total needs and resources, and links that person to a full range of appropriate services, using all available funding (and informal) sources./coordination requirement is designed to assist the policyholder in accessing the long-term careCare given to someone who can no longer perform activities of daily living. services needed to successfully remain in the most independent setting and with the least out-of-pocket expenses as possible. Using a collaborative process, the care manager works with the policyholder, his or her family and a physician to complete a comprehensive assessment to determine the client’s needs and resources and develop a detailed Plan of Care individualized to meet those needs.

Who pays for long-term care?

Medicare pays very little of the expense associated with long-term careCare given to someone who can no longer perform activities of daily living.. Also, Medigap insurance policies or individual health insurance policies typically do not cover long-term care. Thus, without a long-term care insuranceSpecific type of insurance policy designed to offer financial support to pay for necessary long-term care services. policy, individuals must pay for their long-term care expenses out of their own pocket.

What is inflation protection?

All Partnership-certified policies automatically include an inflation protectionProtects the policyholder from covering the difference between what the insurance policy will pay, which is based on the costs of services when you purchased the policy, and the actual cost of care when you need it. Every Partnership policy is required to have this protection, and the state highly recommends that you protect yourself by only purchasing a policy with inflation protection. benefit that increases the Daily Maximum Amount, all other benefit maximums and the Maximum Lifetime Benefit by 5 percent every year. Without inflation protection, there is little, if any, chance that the policy you buy today will cover the inflated costs of long-term careCare given to someone who can no longer perform activities of daily living. 5, 10 or 15 years down the road.

Why should I consider long-term care insurance if my family said they will take care of me?

Many family members will find it difficult to provide an adequate level of care, even though they will likely want to try. Additionally, family caregivers frequently see dramatic changes in their own lifestyles that negatively impact their relationships with their spouse, children and even the loved ones for whom they are caring. Because caregivers often work full-time, their job productivity and ability to advance professionally is also negatively impacted.

What types of Partnership policies are available?

There are two types of Partnership policies:

  1. Facility-only that pays for care in a residential care or nursing facility
  2. Comprehensive that covers care in the home or community, in addition to a residential care or nursing facility
How does the Partnership work?

The Partnership is an innovative public/private alliance between consumers, the state of California and five private insurance companies, plus the California Public Employees’ Retirement System (CalPERS). The Partnership endorses high quality, affordable long-term care insuranceSpecific type of insurance policy designed to offer financial support to pay for necessary long-term care services. policies targeted to middle-income Californians – those with the highest risk of becoming impoverished due to the high costs of long-term careCare given to someone who can no longer perform activities of daily living..

Do Partnership policies cost more than non-Partnership policies?

Partnership policies are priced by each of the partner insurance companies. A Partnership policy will cost the same as a traditional policy with the same benefits and features. The asset protection feature does not increase the cost of insurance.