Understanding the Ohio Long-Term Care Partnership Program

Why is planning for your future long-term care needs so important? Statistics show that a significant majority – at least 70 percent – of individuals over the age of 65 will require some form of long-term care services during their lifetime. It’s a common misconception that Medicare or standard health insurance will cover these costs, but in reality, they typically do not cover the type of long-term care that most people will eventually need. Therefore, proactive planning is crucial to ensure you can access the care you may require in the future without depleting your assets.

The federal government, through the Deficit Reduction Act of 2005, has emphasized individual responsibility in planning and paying for long-term care. This act not only made it more challenging to qualify for Medicaid-funded long-term care but also broadened the scope of Partnership Programs like the Ohio Long-Term Care Partnership Program.

A Partnership Program represents a collaborative effort between a state government, private long-term care insurance companies operating within that state, and the residents who purchase long-term care Partnership policies. The primary goal of the Ohio Long-Term Care Insurance Partnership is to make purchasing more manageable, shorter-term, yet comprehensive long-term care insurance policies a valuable strategy. It achieves this by linking these specific “Partnership-qualified” policies with Medicaid benefits for individuals who continue to need care even after their insurance benefits are exhausted.

Partnership-qualified policies are subject to specific criteria that may vary from state to state. Generally, these policies are required to offer comprehensive benefits, encompassing both institutional and home-based care services. They must also be Tax Qualified, provide specific consumer protections, and incorporate state-determined provisions for inflation protection.

Often, the main distinction between a partnership-qualified policy and other long-term care insurance policies available in a state lies in the mandated amount and type of inflation protection. It’s important to note that the State of Ohio does not have a dedicated office specifically for the Partnership program. The program is implemented through amendments to the state’s Medicaid laws, with the state department of insurance overseeing the regulation of these policies.

If you are unsure whether your existing policy is Partnership-qualified, resources are available to help you determine its status.

Income and Asset Protection through Ohio Partnership Policies

One of the most significant advantages of an Ohio Partnership for Long-Term Care qualified policy is the asset protection it offers. Purchasing such a policy grants you the right to apply for Medicaid under modified eligibility rules. These rules include a vital feature known as an ‘asset disregard.’ This provision allows you to retain assets that would typically be beyond the standard Medicaid asset limits if you need to apply for and qualify for Medicaid to cover further long-term care expenses. The amount of assets that Medicaid will disregard is directly equivalent to the total benefits you actually receive from your Partnership-qualified long-term care policy.

Because these Partnership policies are required to include inflation protection, the total benefits you receive over time can exceed the initial amount of insurance coverage you purchased, further enhancing your asset protection.

For example, if you have a Partnership-qualified long-term care insurance policy and receive $300,000 in benefits, you can then apply for Medicaid and, if you meet the eligibility criteria, protect $300,000 worth of your assets in addition to the standard State Medicaid asset threshold. In many states, this asset threshold is as low as $2,000 for a single individual. Asset thresholds for married couples are typically more generous, but the Partnership program provides an extra layer of security.

In the past, individuals sometimes used trusts to protect assets, but current regulations have made this strategy less effective. Today, only an irrevocable trust might offer some asset protection, and even then, it is subject to a stringent 60-month “look-back” period. This means assets must be transferred into the trust at least 60 months before applying for Medicaid to be considered exempt. Planning that far in advance involves considerable uncertainty.

With a qualified partnership policy, personal assets up to the total value of benefits paid are disregarded when Medicaid calculates asset eligibility. For every dollar of insurance benefits paid out, one dollar of your assets is shielded from Medicaid’s asset limit. This crucial benefit means you can preserve those assets instead of being forced to spend them down to meet Medicaid eligibility requirements.

Furthermore, a Partnership policy offers protection against estate recovery. Estate recovery is a process where the state seeks to recoup the costs of your care paid by Medicaid from your estate after your death. Additionally, some states have filial responsibility laws that could potentially require adult children to financially contribute to their parents’ Medicaid expenses. An Ohio Partnership policy can mitigate these financial risks, preserving your legacy and protecting your family from potential financial burdens.

Illustrative Example of the Ohio Partnership for Long-Term Care in Action

Consider John, who purchases an Ohio Partnership for Long-Term Care policy with an initial value of $300,000. Years later, due to the policy’s inflation protection, he receives benefits totaling $400,000 to cover his long-term care needs. Eventually, John requires more long-term care services but has exhausted his insurance benefits and needs to apply for Medicaid.

If John’s policy had not been Partnership-qualified, he would be limited to keeping only $2,000 in assets to qualify for Medicaid. He would be required to spend down any assets exceeding this limit. However, because John wisely invested in a Partnership-qualified policy, he is allowed to retain $402,000 in assets ($2,000 standard Medicaid asset limit + $400,000 asset disregard) and still qualify for Medicaid. This example clearly demonstrates the significant asset protection offered by the Ohio Long-Term Care Partnership Program.

Addressing the Unfunded Liability of Long-Term Care

Long-term care represents a substantial unfunded liability for both families and government programs today. Recent legislative actions underscore the government’s position that private insurance must play a leading role in financing Americans’ long-term care needs. Despite this, a significant portion of the 78 million Baby Boomers nearing retirement age have not adequately planned for their potential long-term care expenses.

Moreover, many retirees who once believed they could self-fund their long-term care costs are now facing the challenge of protecting their diminishing assets in fluctuating economic conditions, making self-insurance a less viable option.

Benefits of Ohio Partnership for Long-Term Care Policies

Ohio Partnership for Long-Term Care qualified policies are specifically designed to help you maintain your independence, preserve your quality of life, and safeguard your assets. These Partnership policies offer the same broad range of benefits and options as non-Partnership long-term care insurance policies, and importantly, they are priced comparably to non-Partnership policies.

Key benefits of Ohio Partnership for Long-Term Care policies include:

  • Flexible daily or monthly benefit amounts
  • Choice of elimination period or deductible to manage premium costs
  • Comprehensive coverage spanning home care, adult day care, and facility care
  • Benefit period options (pool of money) to suit different needs
  • Availability of discounts to potentially lower premiums

A defining feature of a Partnership policy is the mandatory age-appropriate inflation protection. This feature automatically increases your benefit levels over time to keep pace with the rising costs of long-term care services. Partnership policies are required to include inflation protection at the time of purchase, based on the insured’s age:

  • Age 60 and younger: Automatic compound inflation protection is mandatory.
  • Ages 61–75: Any form of inflation protection is acceptable (compound or simple).
  • Age 76 and older: Inflation protection is optional and at the discretion of the policyholder.

It is crucial to note that the Guaranteed Purchase Option (GPO) or Future Purchase Option (FPO) inflation benefits, often offered by insurance carriers, typically do not meet the inflation protection requirements for Partnership policies unless you are age 76 or older. This is because these options are considered optional, as the policyholder can choose not to exercise them.

Policy Underwriting and Qualification

Qualifying for an Ohio Partnership for Long-Term Care policy involves a medical underwriting process, similar to traditional long-term care insurance. Generally, the younger and healthier you are when you apply, the better your chances of qualifying at favorable rates and with lower premiums. Resources are available to help you understand potential health conditions and medications that may affect your ability to qualify for coverage.

We offer Ohio Partnership for Long-Term Care Insurance Policies from state-approved insurance companies. For more detailed information about Medicaid programs, you can visit the official Medicaid website. To receive a personalized quote for Ohio Partnership for Long-Term Care from leading insurance providers, you can fill out our online quote request form.

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