LTCP Eligibility Criteria

<%@LANGUAGE="JAVASCRIPT" CODEPAGE="65001"%> LTCP Eligibility Criteria

Long-Term Care Partnership

Initial Protection

Process Introduction

LTCP Initial Determination

HealthQuest Response

LTCP Eligibility Criteria

In order to protect assets, a client must meet all of the following:

Request MA payment of LTC services.

Has received benefits from a qualified LTC insurance policy (Partnership policy).

Meet all eligibility criteria for MA payment of LTC services, with two exceptions.

Roddy is requesting MA-LTC due to residence in an LTCF. He owns a checking account with an $8,000 balance. He meets all basic MA and MA-LTC eligibility requirements. Roddy has a qualified Partnership policy which has paid out $7,000 in LTC benefits.

Consider Roddy to have met the three LTCP eligibility criteria:

He is requesting MA-LTC.
His qualified LTC Partnership policy has paid $7,000 in LTC benefits.
He is over assets, but meets all MA-LTC eligibility criteria. By protecting $7,000 of his checking account for protection his asset total will be within limits.

Tyra is requesting MA-LTC to receive services through the BI waiver. She owns a certificate of deposit (CD) with a cash value of $20,000. Two years ago she transferred ownership of another CD resulting in a transfer penalty of 24.54 month. Tyra meets all basic MA and all other MA-LTC eligibility requirements.

Tyra’s qualified Partnership policy has paid $35,000 in LTC benefits which she has received in her home.

Conclude that Tyra has met the three LTCP eligibility criteria.

She is requesting MA-LTC.
Her qualified LTC Partnership policy has paid $35,000 in LTC benefits.
Although Tyra is over assets and has a transfer penalty she meets all other basic MA and MA LTC eligibility requirements Tyra will be able to protect the entire $20,000 cash value of the CD she owns, thereby reducing her total assets to within limits. The transfer penalty does not prohibit Tyra from protecting assets.

Tyra is eligible for basic MA because her MA eligibility was based on her request for MA-LTC at which time she was able to reduce her asset total by protecting assets.

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LTCP Basics

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Updated September 21, 2021.
Copyright © 2011 Health Care Eligibility and Access (HCEA).