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Indiana LTC Partnership Program 7 Hours CE Credit. Insurance Career Training, Inc. www.insurancecareertraining.com. You may access this class presentation after class at www.insurancecareertraining.com/classhandouts The file password is taurus282. LONG TERM CARE INSURANCE IN INDIANA.
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Indiana LTC Partnership Program7 Hours CE Credit Insurance Career Training, Inc. www.insurancecareertraining.com
You may access this class presentation after class at www.insurancecareertraining.com/classhandoutsThe file password is taurus282
Planning for Your Long Term Care Needs • Good News – We Are Living Longer • Bad News – We Are Living Longer • 7 out of 10 individuals will need Home Health Care some time during their lives. • Currently, 40% of those using long term care services in the U.S. are between the ages of 18 and 64. • Overall, individuals living over the age of 65 will have a 60-70% chance of needing some type of long term care service
As a population, we are living longer because of healthier lifestyles, new medical technology, and drug treatments. These medical advances enable us to live with a mental or physical condition longer than ever before. A 65 year old individual today is expected to live well into his/her late 80’s. Because we are aging and living longer, our ability to perform normal activities of daily living could be hindered due to a medical issue. Long term care services assist an individual with everyday activities such as eating, bathing, dressing, and mobility that are hindered because of a medical or mental condition.
The Indiana Long Term Care Insurance Program (ILTCIP) is an innovative working partnership between the State of Indiana and private long term care insurance companies. Indiana has taken the lead in helping its residents protect their hard-earned life savings from the high cost of long term care by promoting the awareness of long term care.
All long term care insurance policies available from insurance companies are not the same. Policies are approved by the Indiana Department of Insurance as meeting required state statutes. “Partnership policies” offer the consumer additional benefits for their long term care needs and protection for their savings. In addition, Partnership insurance policies qualify for a state tax deduction helping Hoosiers to protect even more of their savings.
INDIANA DOI • Supervises the organization, regulation, examination, rehabilitation, liquidation, and conservation of all insurance companies in Indiana; issues a certificate of authority to a company licensed to do business in Indiana • Enforces, administers, and executes the insurance laws of Indiana • Regulates insurance agent licensing requirements
INDIANA DOI • LTC LICENSING REQUIREMENTS: • Resident • Be licensed to sell health insurance; AND • Complete an initial 8-hour basic long term care insurance courses; AND • Complete 5 hours of LTCI CE every 2 years to maintain eligibility to sell LTCI • If selling partnership policies, complete a one-time 7 hour IN Partnership specific course
SHIP PROGRAM • Provides free health insurance information for seniors and pre-retirees • Part of a federal network of SHIP programs located in every state • In Indiana, SHIP is sponsored by the Centers for Medicare and Medicaid Services
SHIP PROGRAM • Provides educational materials and brochures • Helps explain the Medicare program • Educates how to file Medicare claims and how to appeal Medicare decisions • Explains how to make informed decisions about health care policies • Informs a Medicare beneficiary or health insurance policyholder of their rights
SHIP PROGRAM • Shows how to evaluate the various prescriptions, Medicare supplement, and LTC insurances available • Refers to appropriate agencies for additional help • Provides a speaker for presentation to a group, club, or senior center
LTC INSURANCE IN INDIANA • Two categories of LTC insurance are approved by IDOI for sale in Indiana: • Indiana Long Term Care Insurance Program policies (Partnership) and • Traditional Long Term Care insurance policies
LTC INSURANCE IN INDIANA • Asset Protection • Only LTC insurance policies approved under the Indiana LTC Insurance Program provide Medicaid Asset Protection • To identify if a LTC policy is a Partnership policy (qualifies for asset protection), special wording is on 1) Outline of Coverage, 2) application, and 3) front page of the policy
FAVORABLE TAX STATUS • Indiana residents who pay premiums for policies approved under the Indiana LTC Partnership Program can receive a state tax deduction • A taxpayer may take this deduction only for premiums paid (during the tax year) for an Indiana Partnership policy for himself/herself, a spouse, or both taxpayer and spouse • The tax break is a deduction, not a credit
FAVORABLE TAX STATUS • Federal • HIPAA of 1996 is a federal law providing limited federal tax breaks for owners of LTC policies that meet specific standards (tax-qualified)
FAVORABLE TAX STATUS • Tax Breaks Provided • Premiums • Premiums for self-employed • Benefits
FAVORABLE TAX STATUS • Questions • How do I know if a policy is a federally tax-qualified LTC insurance policy? • What are some of the features included in federally tax-qualified LTC policies? • Benefit Triggers • Non-Forfeiture Benefit • Required Consumer Protection Standards
HISTORY • Legislative History • Robert Wood Johnson Foundation Planning Grant • Steering Committee and Task Force • Program Design • Attempts at Federal Legislation • Medicaid State Plan Amendment Submitted • Robert Wood Johnson Foundation Implementation Grant • Plan Amendment Approved • Program Implementation • Amendments
PROGRAM FEATURES • One Year Policies • Minimum Daily Benefit • Pot of Dollars (or Pool) • Inflation Protection • Pooled Risk • Comprehensive Policies • Case Management • Insured Event Determination • Tax-Qualified ILTCIP policies • Non-tax qualified ILTCIP policy
PROGRAM FEATURES • Measuring cognitive impairment for ILTCIP policies • Issue Age • 30-Day Free Look • Step-Down Coverage Provision • Contact Designee • Minimum Reinstatement Period • Coordination of Benefits • No Policy Change Without Acceptance • Assisted Living Facility Benefit • Riders
DEFICIT REDUCTION ACT • Expansion • Reciprocity for Medicaid Asset Protection • Medicaid Eligibility
ASSET PROTECTION • Medicaid Asset Protection is a special state-added benefit found only in LTC policies approved by the Indiana LTCIP • The Medicaid asset protection feature with a Partnership LTC policy provides additional financial protection if a policyholder applies for Medicaid eligibility • The state has approval from the federal government to offer asset protection only, this program does not offer income protection
ASSET PROTECTION • Combination Asset Protection • Total Asset Protection • Initial Purchases • Policy Effective Date • Why the Offer is Important • Benefits Used • Reduction of Coverage • Policies with Shared Benefits • Growth of Assets
RECIPROCITY • Questions Regarding Reciprocity • What does this mean for Indiana Partnership policyholders? • Does this change my Partnership policy if I remain in Indiana • If my Partnership policy was effective before April 1, 2009, am I covered under this reciprocity agreement? • What requirements have to be met to qualify for asset protection in other states? • Does this Reciprocity Agreement guarantee that I will have asset protection with other states in the future?
MEDICAID ASSET PROTECTION • There are two types of asset protection – Total and Dollar-for-Dollar • Total Asset Protection means all of your assets will be disregarded during the Medicaid eligibility process, should you choose to apply for help from Indiana Medicaid • Dollar-for-dollar asset protection means that you will be allowed to retain one dollar of your assets for every one dollar of benefits used in your Partnership policy
FAQ • Why would I want to purchase a LTC policy? • Doesn’t Medicare pay for LTC services? • What is the ILTCIP? • Doesn’t the State of Indiana sell policies under the Partnership program? • What is the difference between a traditional LTC policy and a Partnership policy? • What is asset protection?
FAQ • Does a Partnership policy cost more than a traditional LTC policy • How do I purchase a Partnership LTC Policy? • How do I know if I have a Partnership policy? • If my policy is not a Partnership policy, can I add asset protection? • I bought a LTC policy after 1993, but my agent did not discuss a Partnership policy with me. Is this illegal? • How much asset protection will my Indiana Partnership policy provide?
FAQ • How do I find out how much coverage is required for total asset protection? • Is my income protected under an Indiana Partnership Policy? • Is my LTC policy good if I move to another state? • Can I take a tax deduction for my LTC policy? • Since I have a Partnership LTC policy, am I automatically eligible for Medicaid?
GENERAL INFORMATION • Medicaid is a federal/state funded medical assistance program that pays for approved and needed medical care for persons who meet specific eligibility requirements • Applications for Medicaid assistance are taken at the County office of Family and Children
GENERAL INFORMATION • Eligibility: • Applications must be in one of the following categories: • Low income families with dependent children • Pregnant women • Newborns (up to age 1 if born to Medicaid recipient) • Age 65 or older • Individuals age 18,19, 2012 • Children under 19 • Blind • Refugees
GENERAL INFORMATION • And Meet medical criteria • Meet the financial criteria • Income (differs for individual or married couple) • Countable assets (differs for individual or married couple)