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Partnership for Long Term Care

Fact Sheet

University of Maryland, National Program Office
Mark R. Meiners, Ph.D., Director

The Partnership for Long Term Care provides an alternative to spending down or transferring assets by forming a partnership between Medicaid and private long term care insurers.

Partnership states have focused on creating affordable products that encourage people to self-insure, enable purchasers to provide better protection against impoverishment, and reduce long term care costs for the Medicaid program.

By design, the Partnership policies are Medicaid budget neutral. While states must forgive part of the insured's potential spend-down, the insurance company is absorbing costs for long-term care that would have been Medicaid's responsibility. The extremely small number of policy-holders who have actually accessed Medicaid (<50) illustrates the effectiveness of the Partnership in meeting the budget neutrality goal.

Policy Types

Dollar-for-Dollar Model (CT and CA)

Policies must cover at least one year at issue and pay a minimum daily benefit (determined by each state)
Once policy benefits are exhausted, every dollar paid out by the insurer will be deducted from resources counted for Medicaid eligibility

Total Assets Model (NY)

Policies must cover three years of nursing home care, six years of home care or a combination of the two
Once policy benefits are exhausted, protection is granted for all assets, but an individuals income must be devoted to the cost of care

Hybrid Model (IN)

Policies must cover at least one year at issue and pay a minimum daily benefit
The value of coverage purchased and later used, determines the method used for determining asset protection in Medicaid eligibility
If the amount purchased is equal to or above the state-set amount for the policy effective year, total asset protection is applied
If the amount purchased is less than the state-set amount, the dollar-for-dollar method is used
Regardless of which method is used, an individual's income must be used for costs of care

Current State Data

	California (through 4Q 2003)	Connecticut (through 4Q 2003)	Indiana (through 2Q 2004)	New York (through 2-3Q 2003)	Four State Total
Total Applications Received:	77,423	40,167	37,743	71,949	227,282
Applications Denied:	13,439	4,817	5,445	11,701	35,402
Applications Pending & Withdrawn:	0	2,282	334	6,719	9,335
Total Policies Purchased:	63,984	33,068	31,964	53,529	182,545
Policies Dropped:*	6,000	3,256	3,434	5,286	17,976
Policies Not Taken Up:	3,316	2,496	2,434	5,359	13,605
Total Policies In Force (active):	54,632	26,938	26,707	41,732	150,009
Policyholders Who Received Service Payments:	624	244	210	896	1,974
* Does not include drops reported as deaths, rescissions or exhausted benefits.

Center for Health Policy Research and Ethics