Nearly 70% of senior citizens will require some long-term care services at some point in their lives. What they do not realize is that Medicare and private health insurance do not pay for the majority of long-term care services that most people need. Long term care is defined as care that is necessary to assist an individual with the activities of daily living, such as bathing, eating and dressing, as well as medical issues from chronic or long term illnesses.
New York is one of just a few states in the country that provide a partnership of the public and private sectors to meet the increasing need for long term care solutions. The New York State Partnership for Long-Term Care is a partnership program that combines long-term care insurance and Medicaid Extended Coverage to help New Yorkers financially prepare for the possibility of needing nursing home care, home care or assisted living services. The program allows users to protect some, or all of their resources, depending on the insurance plan purchased, if their long-term care needs to extend beyond the period covered by their private partnership insurance policy.
Both individual and group Partnership plans are available in New York. Partnership long-term care insurance policies contain unique features and must be approved by the Insurance Department of New York. Some of these features include:
- Use of Medicaid Extended Coverage when the private policy benefits are exhausted – resulting in a lifetime of coverage for long-term care.
- Minimum standards for Partnership policies, such as a daily benefit of $241 for nursing homes, and $121 per day for home-based and community-based services;
- Independent review of benefits denied by an insurer; and
- Policy sales and use of services monitored by the Partnership to ensure that the program is meeting the needs of participants.
By understanding and planning for long-term care, many people can retain their independence and allow their family to continue with a lifestyle that is not hampered by a family member’s long-term care needs. Normally, long-term care expenses result in many people turning to Medicaid for assistance, which requires that assets are sold or transferred in a certain manner for eligibility. Long-term care services in the Medicaid Extended Coverage program are obtained without a spend down of all or part of your assets, depending on your policy choice.
The New York State Partnership for Long-Term Care aims to create long-term care insurance products to encourage people to self-insure, provide better protection against impoverishment, and reduce long-term care costs for the Medicaid program. Consult with an estate planning attorney to determine how this program can fit into your estate plan.
The Law Office of Michael Robinson, P.C. is a member of the American Academy of Estate Planning Attorneys.