California Partnership for Long Term Care

What is a Partnership Policy?

All Partnership-approved policies are required to have certain protections to ensure you of a quality policy that meets your needs. These include:

  • Inflation ProtectionProtects the policyholder from covering the difference between what the insurance policy will pay, which is based on the costs of services when you purchased the policy, and the actual cost of care when you need it. Every Partnership policy is required to have this protection, and the state highly recommends that you protect yourself by only purchasing a policy with inflation protection.
  • Asset Protection
  • Comprehensive Care ManagementA process to assess, plan, coordinate and monitor long-term care needs and services. Care management/care coordination takes an all-inclusive look at a person’s total needs and resources, and links that person to a full range of appropriate services, using all available funding (and informal) sources.
  • Rate Increases Regulated by the California Partnership for Long-Term CareCare given to someone who can no longer perform activities of daily living.

Partnership policies have two unique features that make them especially attractive.

Care Management: The Partnership requires that a Care Management Provider Agency, approved by the State Department of Health Care Services and independent from the insurer, provide care coordination for Partnership policyholders.

Using a collaborative process, the care manager works with the policyholder, their family and physician to complete a comprehensive assessment to determine the client’s needs and resources, and develop a detailed Plan of Care individualized to meet those needs.

  • Plan of Care: In developing the plan of care, the care coordinator will consider the unique needs of the client and recommend alternatives for how those needs can best be met. It is likely that without the help of a care coordinator, a policyholder or their family would have no idea of where to find someone to provide the necessary care. Partnership regulations require the care coordinator to consider how the policy benefits can help meet the policyholder’s needs and how the needs might also be met through other sources, perhaps through community services or the client’s health coverage, etc. These other sources can help reduce the out-of-pocket expenses to the policyholder as well as help the policy benefits last as long as possible. The identification of other sources of care can be especially important for a person who has a policy designed to pay benefits for only one or two years. Furthermore, since the Partnership requires the care coordinator to live in and be familiar with the community in which the policyholder resides, he or she will have a good understanding of where the quality providers are.
  • Care Implementation and Monitoring: In addition to completing a comprehensive assessment and plan of care, the care coordinator can also contact the caregivers and arrange for them to be in the home to provide care at the required times, negotiate rates of payment and monitor the quality of the services provided, if desired by the policyholder.

Lifetime Asset Protection: This feature assures that catastrophic long-term care expenses won't reduce you to poverty even if you run out of insurance benefits. That's something other long-term care insuranceSpecific type of insurance policy designed to offer financial support to pay for necessary long-term care services. policies do not offer.

Here is how this special feature works. When you need care, your Partnership-approved private long-term care insurance policy pays for your care in the same way other high quality long-term care policies would, but unlike a traditional non-Partnership policy, each dollar your Partnership policy pays out in benefits entitles you to keep a dollar of your assets if you ever need to apply for Medi-Cal services.

For most of you, the benefits of a Partnership insurance policy will provide all the care you will ever need. But you won't have to impoverish yourself if you run out of insurance benefits and still need care. You can apply to Medi-Cal for assistance in paying the costs of your continued care and not have to "spend down" your savings to the poverty level. Each dollar your Partnership policy pays in benefits for your care is protected against Medi-Cal "spend down" rules. You may have to apply a portion of your income toward the cost of your care, but the assets you protected by purchasing a Partnership policy remain yours, for you and your spouse's use or to leave to loved ones.

"Every once in a while an idea comes along that has some real merit. The California Partnership is a case in point." Senior World, October, 1994.

 

Watch the Video: Exclusive features of Partnership policies