LTC Insurance TPL Requirements

When an MA-LTC client reports other health care coverage, including LTC insurance, the TPL requirements found below must be met. A summary of this information can be found on the LTC Insurance (PDF) handout.

Identify potential and current sources of health care coverage.

The client must report and cooperate in identifying other health care coverage they currently have or that they could have. This includes reporting LTC insurance on any of the following:

MHCP Application for Payment of Long-Term Care Services (DHS-3531).

MHCP Request for Payment of Long-Term Care Services (DHS-3543).

MHCP Application for Certain Populations (DHS-3876).

MNsure Application for Health Coverage and Help Paying Costs (DHS-6696).

Renewal Form.

Provide information about other health care coverage.

The client must provide information about the policy which may include completing a Request for Group Health Plan Information (DHS-3767) or the Appendix A of the MNsure Application for Health Coverage and Help Paying Costs (DHS-6696) and providing a copy of their insurance card.

Enroll in and maintain other health care coverage, as required.

Cost-effective insurance policy, as it applies to LTC insurance, is discussed on the next page of this module.

Cooperate with the rules of the coverage provider.

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LTC Insurance

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