Partial federal government shutdown
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
The Washington State Long-term care partnership (LTCP) program is administered in collaboration between Washington State Health Care Authority (HCA), Washington State Office of Insurance Commissioner (OIC) and the Department of Social and Health Services (DSHS). It is a unique program combining private LTC insurance and special access to Medicaid. The partnership helps individuals financially prepare for the possibility of needing nursing home care, home-based care, or assisted living/adult family home services sometime in the future. The program allows individuals to protect some or all of their assets and still qualify for Medicaid if their LTC needs extend beyond what is covered by their private insurance policy. Section 6021 of the Deficit Reduction Act of 2005 allows for qualified state long-term care partnerships.
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.
Effective February 20, 2017
For purposes of WAC 182-513-1400 through 182-513-1455, the following terms have the meanings stated. See chapter 182-500 WAC and WAC 182-513-1100 for additional definitions.
"Issuer" means any entity that delivers, issues for delivery, or provides coverage to, a resident of Washington, any policy that claims to provide asset protection under the Washington long-term care partnership act, chapter 48.85 RCW. As used in this chapter, issuer specifically includes insurance companies, fraternal benefit societies, health care service contractors, and health maintenance organizations.
"Long-term care (LTC) insurance" means a policy under chapter 284-83 WAC.
"Protected assets" means assets that are designated as excluded or not taken into account upon determination of long-term care medicaid eligibility under WAC 182-513-1315. The protected or excluded amount is up to the dollar amount of benefits that have been paid for long-term care services by the qualifying long-term care partnership policy on the medicaid applicant's or client's behalf. The assets are also protected or excluded for the purposes of estate recovery under chapter 182-527 WAC, up to the amount of benefits paid by the qualifying policy for medical and long-term care services.
"Qualified long-term care insurance partnership" means an agreement between the Centers for Medicare and Medicaid Services (CMS), and the health care authority (HCA) which allows for the disregard of any assets or resources in an amount equal to the insurance benefit payments that are made to or on behalf of a person who is a beneficiary under a long-term care insurance policy that has been determined by the Washington state insurance commission to meet the requirements of section 1917 (b)(1)(c)(iii) of the act. These policies are described in chapter 284-83 WAC.
"Reciprocity Agreement" means an agreement between states approved under section 6021(b) of the Deficit Reduction Act of 2005, Public Law 109-171 (DRA) under which the states agree to provide the same asset protections for qualified partnership policies purchased by a person while residing in another state and that state has a reciprocity agreement with the state of Washington.
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.
Effective February 20, 2017
A LTC partnership policy is a LTC policy that has been approved by the office of insurance commissioner as a LTC partnership policy described in chapter 284-83 WAC.
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.
Effective February 20, 2017
The following assets cannot be protected under a LTC partnership policy.
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.
Effective February 20, 2017
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.
Effective February 20, 2017
You are not eligible for long-term care (LTC) medicaid when the following applies:
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.
Effective February 20, 2017
You must report changes described in WAC 182-504-0105 plus the following:
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.
Effective February 20, 2017
The Washington long term care partnership program provides reciprocity with respect to qualifying long-term care insurance policies covered under other state long-term care insurance partnerships. This allows you to purchase a partnership policy in one state and move to Washington without losing your asset protection. If your LTC policy is in pay status at the time you move to Washington and you are otherwise eligible for LTC medicaid, Washington will recognize the amount of protection you accumulated in the other state.
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.
Effective February 20, 2017
You can protect assets based on the amount paid by your LTC partnership policy. Assets are protected in both LTC eligibility and estate recovery. If the partnership for long-term care program is discontinued, an individual who purchased an approved plan before the date the program is discontinued remains eligible to receive dollar-for-dollar asset disregard and asset protection under the long-term care (LTC) medicaid 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.
Effective February 20, 2017
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.
Effective February 20, 2017
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.
Effective February 20, 2017
Assets designated as protected prior to death are not subject to estate recovery for medical or long-term care (LTC) services paid on your behalf under chapter 182-527 WAC as long as the following requirements are met:
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.
Financial staff will:
Example
Single applicant with equity interest in a home worth $200,000 and $50,000 in resources applies for long term care services Medicaid.
Applicant has a LTCP policy that has paid out $100,000. The applicant is able to designate up to $100,000 in resources as protected.
Applicant is allowed to have $2,000 in resources. The home is excluded because the applicant is living in a nursing home but intends to return home.
Applicant wants to designate $48,000 of the liquid assets as protected. The applicant wants to designate $52,000 of home equity as protected.
On RES1 screen code SC $48,000 liquid assets LTCP
On RES1 screen code SC $52,000 home equity LTCP
Remarks behind RES1:
Total amount paid by LTCP as of this date: $100,000
LTCP asset form in DMS dated xx/xx/2012
Designating $48,000 in Bank of Trust Savings Account
Designating $52,000 of $200,000 home equity
RES2 screen, code the $200,000 home and indicate PR. Add remarks behind RES2 $52,000 of $200,000 is protected due to LTCP asset designation.
Example
Same example as #1 except it is one year later at the annual review.
The LTCP policy has paid out an additional $60,000 in benefits.
The recipient of Medicaid has designated $112,000 of the $200,000 home equity as protected and $48,000 in the savings account as protected. The recipient of Medicaid has $2,000 in resources in a checking account.
On RES1 screen update SC code to $112,000 of the home equity LTCP. Add remarks behind the RES1 screen and RES2 screen with the updating information.
An overview of LTC Medicaid and the LTC Partnership for consumers
Long-term care Partnership, Frequently Asked Questions
10-438 Long-Term Care Partnership (LTCP) asset designation form
14-194 Medical Coverage Information form
This form is completed when any other medical coverage exists including LTC insurance. Once completed and returned to DSHS, the system will automatically assign to the Health Care Authority Coordination of Benefits Section.
See Long-term care insurance and third party resources for additional information
Chapter 284-83 WAC Long-term Care insurance rules
Office of the Insurance Commissioner Long Term Care Partnership Program
Office of the Insurance Commissioner Long-term care insurance