The Ohio Partnership for Long-Term Care Insurance – also referred to as LTC4Me – is an initiative between the state of Ohio and private insurance companies. The initiative established “partnership qualified policies” which provide coverage for long-term care needs while allowing Ohioans to obtain “Medicaid asset protection.” This benefit is not available with other long-term care insurance policies sold in Ohio and protects the consumer from having to spend down their assets to potentially obtain coverage through Medicaid.
Long-Term Care Insurance Partnership History
A federal law established the federal Long-Term Care Insurance Partnership program, which is administered at the national level by the Centers for Medicare and Medicaid Services (CMS). The law gave Ohio and other states the ability to adopt their own long-term care insurance partnerships if they meet the federal and state law requirements for this type of long-term care insurance.
A 2005 change in the federal law made it possible for new states creating their own partnership programs to allow protection of assets not only at time of application for Medicaid but also at time of estate recovery. To take advantage of this opportunity, in 2007, Ohio Revised Code (ORC) 5164.86 authorized the Ohio Department of Job and Family Services (ODJFS) (now the Ohio Department of Medicaid) to develop the Ohio partnership program in conjunction with the Ohio Department of Insurance (ODI), the Ohio Department of Aging (ODA) and the insurance industry.
Considerations When Purchasing "Partnership Qualified" LTC Insurance
With any insurance policy, it is important for the consumer to choose the type of coverage that fits their needs. Only you can decide if long-term care insurance is right for you. Your decision should depend on personal health and wealth matters.
- When weighing long-term care planning options, get a realistic idea of what you need and how much you can afford to pay.
- Make sure you can pay the premiums and still have enough money for basic needs such as housing, food, medicines, and other important lifestyle considerations.
- Ask a trusted friend or relative to join you when an agent visits your home. Also, have them review the policy to see what you may have missed.
- Shop around — long-term care insurance policies can have big differences in price and benefits.
- Deciding whether to purchase a “partnership qualified” long term care insurance policy should be part of your analysis, especially if you have assets to protect
Frequently Asked Questions
What is the Ohio Partnership for Long-Term Care Insurance?
The Ohio Partnership for Long-Term Care Insurance – also referred to as LTC4ME – is between the state of Ohio and private insurance companies. The partnership was created to encourage Ohioans to plan for their long-term care needs. If you purchase a “partnership qualified” policy, you will gain coverage for long-term care services as described in the policy. If you use that partnership qualified policy to pay for qualified long term care services you also will be allowed to keep more of your assets if you ever need to apply for Medicaid long-term care services.
Ohioans without a partnership qualified policy needing to apply for Medicaid long-term care services must deplete almost all of their assets to qualify for the Medicaid program, because it is a program designed for the very poor. Note: Medicaid also has maximum income requirements in order to be eligible.
How was the Ohio Partnership for Long-Term Care Insurance established?
A federal law established the Long-Term Care Insurance Partnership, which is administered at the national level by the Centers for Medicare and Medicaid Services (CMS). The law gave Ohio and other states the ability to adopt their own long-term care insurance partnerships. The first four long-term care partnership states were New York, California, Connecticut and Indiana, where partnerships have been in place for over 20 years. In 2007, after a change in the federal law expanding the reach of the program, Ohio Revised Code (ORC) 5164.86 authorized the Ohio Department of Job and Family Services (ODJFS) (now the Ohio Department of Medicaid) to develop the partnership in conjunction with the Ohio Department of Insurance (ODI), the Ohio Department of Aging (ODA) and the insurance industry.
How are partnership qualified policies different from traditional long-term care insurance policies?
The main difference between the two types of policies is that partnership qualified policies provide the benefit of Medicaid asset protection. This protection allows you to keep more of your assets should you ever need to apply for Medicaid to help pay for your long-term care costs, based directly on the use of the benefits of the partnership qualified policy.
Why would I need Medicaid if I have a partnership qualified policy?
Long-term care is expensive, and you may have expenses that exceed your long-term care insurance coverage. If so, you can apply for Medicaid to help pay the difference between what the policy covers and what is owed. Owning a partnership qualified policy allows you to keep assets that exceed the typical Medicaid asset limit, to the extent you have used the partnership qualified policy benefits, and still qualify for the Medicaid program.
How does qualified partnership policy work with Ohio’s Medicaid program?
Information coming soon! Check back for fact sheets and other partnership info.
Will Medicaid take the assets protected by a partnership qualified policy after a policyholder is deceased?
Assets which are protected by the partnership qualified policy at the time of the Medicaid eligibility determination will continue to be protected during estate recovery. However, assets like certain special needs trusts, pooled trusts and annuities that are not considered “countable assets” when determining your Medicaid eligibility could be subject to estate recovery.
Will a partnership qualified policy provide coverage in my own home?
Coverage may be available in your home if your care needs qualify under your policy. Additionally, you may be covered if you are in an assisted living facility, adult day care or a skilled nursing facility (nursing home). Ask your insurance agent for more detailed information about your policy’s coverage or review the Ohio Department of Insurance’s LTC Insurance Buyers Guide, entitled, “Guide to Long Term Care Insurance.”
How much do partnership qualified policies cost?
Each insurance company offering partnership qualified policies determines its own premiums. The cost and benefits vary by company, so it's very important to shop around. However, in general the younger you are when you purchase coverage, the lower your annual premium will be.
Do partnership qualified policies contain inflation protection?
Yes. By law, each partnership policy contains a level of inflation protection if you are younger than age 76. The actual level of inflation protection depends upon your age when you purchased the policy. If you are over age 75, the insurer must offer you inflation protection, but you do not have to purchase that option. Inflation protection is an important factor in the cost of the premiums for the policy.
Since it is not uncommon for policyholders to buy policies 20 or 30 years before benefits are actually used, inflation protection enables benefits to increase periodically while the policy is in force.
Are there consumer protections in place for partnership qualified policies?
Yes. The Ohio Department of Insurance must approve insurance products and rate filings, as well as monitor company and agent conduct. This safeguard is in place to ensure rates are actuarially sound and the products meet both state and federal partnership qualified policy requirements. In addition, special subject matter training is required for agents and/or brokers who sell and market partnership qualified policies.
How do I know if a partnership qualified policy is right for me?
Talk to your insurance agent to find a partnership qualified policy that is right for you. Some things you may want to consider are:
- Can you afford to pay for long-term care services if you decide to pay out of pocket?
- Do you have assets you want to protect?
- What health care settings does the partnership policy cover?
- Do you want to protect your family’s standard of living?
- Can you afford the partnership policy premiums?
- Can anyone purchase a partnership qualified policy?
Like other long-term care insurance policies, partnership policies are subject to medical underwriting and coverage may be denied based on various risk factors.
How does Ohio treat partnership qualified policies purchased in other states?
The Ohio Department of Medicaid recognizes partnership qualified policies purchased in other states to the extent the other state does the same. This is called reciprocal recognition. Most states with a partnership program have indicated they practice reciprocity with other partnership states.
Can I exchange my current long-term care policy for a partnership qualified policy?
If your current long-term care policy was purchased on or after August 12, 2002, your insurance company must offer you in writing the option to exchange it for a partnership qualified policy once they enter the long-term care insurance partnership market. The insurance company cannot discriminate on the basis of your age or health status when making the exchange offer.
You have 90 days from the date the offer was made to decide if you want to exchange your policy. An exchange is not guaranteed. You may be required to provide medical information for the insurer to determine if the exchange requires you to purchase increased benefits in order to be recognized as a partnership qualified policy.
How do I purchase a long-term care partnership qualified insurance policy?
You can purchase a partnership qualified policy through a licensed insurance agent. We encourage you to shop around to find the most suitable coverage for you. To find an agent who sells partnership policies, call 800-686-1526 and ask a representative to help you find an agent or a list of insurers that have partnership qualified long term care insurance policy forms.
Are there tax advantages to partnership policies?
Long-term care insurance partnership qualified policies may provide you with tax advantages. Ohio allows an income tax deduction for the cost of unreimbursed long-term care insurance premiums for federally tax qualified plans like partnership qualified policies. Read your tax forms carefully. You may also want to discuss with a tax professional.