Apple Health phone lines down Thursday, April 18
The Apple Health customer service phone lines will be down Thursday, April 18, from 11:30 a.m. to 2:30 p.m. We apologize for the inconvenience. View other ways to contact Apple Health.
The Apple Health customer service phone lines will be down Thursday, April 18, from 11:30 a.m. to 2:30 p.m. We apologize for the inconvenience. View other ways to contact Apple Health.
This section gives an overview of the long-term care partnership insurance program. This program is a collaboration between the Department of Social and Health Services (DSHS), Health Care Authority (HCA) and the Office of the Insurance Commissioner (OIC).
Effective February 20, 2017
Under the long-term care (LTC) partnership program, people who purchase qualified long-term care partnership insurance policies can apply for long-term care medicaid under special rules for determining financial eligibility. These special rules generally allow the person to protect assets up to the insurance benefits received from a partnership policy so that such assets will not be taken into account in determining financial eligibility for long-term care medicaid and will not subsequently be subject to estate recovery for medicaid and long-term care services paid. The Washington long term care partnership program is effective on December 1, 2011.
The following rules govern long-term care eligibility under the long-term care partnership program:
This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.
For the purposes of Medicaid eligibility, long-term care is for individuals residing in a medical institution (primarily a nursing home) for 30 days or more or on a Home and Community based Waiver (HCB Waiver).
"Institutionalized individual" means an individual who has attained institutional status as described in WAC 182-513-1320
"Institutional Services" means services paid for by Medicaid or state funds and provided in a medical institution, through a Home and Community Based (HCB) Waiver or Program of All-Inclusive Care for the Elderly (PACE).
"Home and Community Based Services" (HCBS) means services provided in the home or a residential setting to individuals assessed by the department.
"Home and Community Based (HCB) Waiver programs" means Section 1915 (c) of the Social Security Act enables states to request a waiver of applicable federal Medicaid requirements to provide enhanced community support services to those Medicaid beneficiaries who would otherwise require institutional care.
Additional definitions used in long-term care eligibility
Eligibility requirements for long-term care are found in WAC 182-513-1315. Some of the key requirements are:
WAC 182-513-1350 describes resource eligibility for long-term care
Income and Resource standard charts used in long-term care eligibility
Washington State Long-term care partnership program main page (Long-Term care Medicaid manual, includes the Washington Administrative Code (WAC) rule on eligibility)
Individuals with LTC partnership policy must submit a DSHS 10-438 LTCP Asset Designation form to Washington State Medicaid at the time of application and at each annual review in order to designate assets as protected based on the dollar amount paid for services by the LTC Partnership Policy. This will track protected assets for both LTC Medicaid eligibility and Estate Recovery purposes.
DSHS 10-438 Long-Term Care Partnership Asset Designation Form
Long-term care eligibility manual includes the Washington Administrative Code
Questions and Answers on Medicaid for nursing home residents by Columbia Legal Services