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Long-Term Care Partnerships
Purpose: 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.
Financial staff will:
- Request a copy of the long-term care partnership policy
- Request a completed DSHS 10-438 Long-term care partnership asset designation form
- Part A is completed by the insurance company that has issued the policy.
- Part B is completed by the Medicaid applicant/recipient. This section identifies which assets the individual is requesting to designate as protected.
- Determine the amount of resources the client is able to designate as protected based on the dollar amount paid out by the long-term care partnership insurance.
- Code the protected assets on the ACES RES1 screen using code SC. Add remarks behind the RES1 screen:
- SC = assets that are excluded based on the dollar amount paid out by a LTCP policy.
- Total amount paid out by LTCP as of this date: ________________________
- LTCP asset designation form in DMS dated:
- At each annual review, determine if additional assets can be protected based on the dollar amount paid out by a LTCP policy.
- A medicaid client may transfer protected assets, but this will reduce the total amount of assets they are able to protect based on the dollar amount of the transfer.
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.
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.
Long-term care Partnership information for consumers
Medical Coverage Information form and third party resource
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
Office of the insurance commissioner