LTC Partnership flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Dollar-for-dollar asset disregard

A Partnership feature in which each dollar of policy benefits paid increases the countable assets the insured may keep and still qualify for Medicaid long-term care coverage.

Deficit Reduction Act of 2005

Federal law that let all states establish Partnership programs through Medicaid state plan amendments, replacing the earlier waiver-only approach and standardizing dollar-for-dollar disregard.

Original Partnership states

California, Connecticut, Indiana, and New York operated Partnership programs before the 2005 federal law, and their approved variations explain many of the differences among states today.

Partnership reciprocity

An arrangement under which a Partnership policy purchased in one participating state may be recognized for asset disregard if the insured later moves to another Partnership state.

Partnership tracking requirement

Insurers must report policy and benefit payment data to the state so the Medicaid agency can calculate the disregard amount when the insured applies for benefits.

Partnership program purpose

Partnership programs aim to increase private long-term care coverage and reduce Medicaid reliance by rewarding policyholders with added asset protection at Medicaid application.

State plan amendment

The Medicaid mechanism a state uses to adopt a Partnership program under the 2005 federal framework, subject to federal approval of its policy and reporting design.

Activities of daily living triggers

Most long-term care policies begin benefits when the insured cannot perform two of six ADLs for at least 90 days or has a severe cognitive impairment.

Elimination period

The waiting period, often 0 to 90 days, before policy benefits begin; a longer period reduces premium but raises the insured's out-of-pocket cost at claim time.

Benefit pool calculation

The total available benefit equals the daily or monthly maximum multiplied by the number of days in the benefit period; spending below the maximum can extend the pool.

Compound inflation protection

A rider that increases the benefit amount by a percentage each year applied to the growing balance, producing larger future benefits than a simple inflation increase.

Contingent nonforfeiture

A consumer protection that provides a paid-up policy or reduced benefit if coverage lapses after the policy has been in force for a state-specified period.

Tax-qualified long-term care contract

A policy meeting Internal Revenue Code section 7702B, which allows benefits to be excluded from income and premiums to be deducted within age-based limits.

Benefit period

The length of time or total dollar pool over which benefits are payable; common choices range from two to five years or a lifetime maximum.

Cognitive impairment trigger

A benefit trigger based on severe cognitive impairment such as Alzheimer's disease, which can start benefits even when the insured can still perform daily activities.

Partnership inflation requirement

Buyers under age 61 must have compound annual inflation of at least 5 percent; buyers age 61 to 75 need some inflation protection; buyers over 75 need none.

Partnership residency rule

The insured generally must be a resident of the participating state when the policy is issued for the policy to earn that state's Partnership asset disregard.

Partnership disclosure statement

A required document explaining that the policy is Partnership-qualified, how the asset disregard works, and that Medicaid eligibility is not guaranteed.

State-specific Partnership requirements

States may add requirements such as minimum benefit periods or home care offers, so a policy qualified in one state may not qualify in another.

Partnership conversion pathway

A state-approved method, where offered, for endorsing or replacing a pre-Partnership policy so it gains qualified status; availability varies by state.

Partnership qualification loss

Material policy amendments or loss of tax-qualified status can remove Partnership qualification, so endorsements changing benefit structure require review against state rules.

Tax-qualified requirement

A Partnership policy must first be a tax-qualified long-term care contract under Internal Revenue Code section 7702B before state Partnership rules apply.

Medicaid countable assets

Resources counted toward the Medicaid long-term care asset limit, excluding certain items such as an occupied home in some circumstances, compared to a state threshold.

Community spouse resource allowance

The share of countable resources the spouse living at home may retain, bounded by federal minimum and maximum amounts, applied before any Partnership disregard.

Five-year look-back

The period Medicaid reviews for uncompensated asset transfers before an application; transfers within it can create a penalty period of ineligibility.

Medicaid estate recovery

State authority to recover Medicaid long-term care costs from the recipient's probate estate, subject to federal limits and hardship and survivor protections.

Earned asset protection

Partnership protection equals benefits actually paid, so a policy that never pays a claim produces no asset disregard at Medicaid application.

Suitability assessment factors

Review of assets, income, health, family caregiving, and premium sustainability to judge whether a Partnership policy fits the client's long-term care plan.

Low-asset client consideration

A client with few countable assets may gain little from the disregard, so alternatives such as Medicaid planning or a smaller policy may fit better.

No eligibility guarantee

A Partnership policy does not guarantee Medicaid eligibility; assets above the disregard amount and income limits still apply at application.

Agent disclosure duties

Marketing Partnership policies requires explaining the Medicaid interaction, inflation protection trade-offs, and the possibility of future premium increases.

Spend-down

The process of reducing countable assets below the Medicaid limit, for example by paying for care, before qualifying; the Partnership disregard reduces the amount spent down.