F Long-Term Care Partnership Program Exclusion

 

Policy

Section 1917(b) of the Social Security Act allows states to develop Long-Term Care Partnership Programs (LTCPP) to increase the number of people buying private long-term care insurance. The Arizona Long-Term Care Partnership program began July 1, 2008.

The State Insurance Commissioner, or other state official charged with regulation and oversight of insurance policies sold in the state, determines whether a policy meets the State Insurance Department’s LTCPP requirements.

1) Treatment

People with a qualifying policy get a resource exclusion equal to the amount of benefits paid out under the policy before the month the person applies for ALTCS.

NOTE     An amount equal to the resource exclusion is also excluded from collection by the Estate Recovery program.

See Long-Term Care Partnership Program Exclusion for an example.

If the LTCPP policy is still paying for services during or after the month of the ALTCS application, the payments are treated as Medical Insurance Payments (see MA606QQ).

 

2) LTCPP Resource Exclusion and Transfers

The LTCPP resource exclusion is not tied to any specific resources. So, it cannot be used to exclude a resource transferred without receiving fair value and avoid a penalty period.

 

3) LTCPP Policies from Other States

Federal law allows states to enter into agreements to honor LTCPP policies purchased in another state. Arizona is a participating state.

When an LTCPP policy was bought in another state, submit a Policy Clarification Request (PCR) through PATS. The Office of Eligibility Policy (OEP) will determine whether or not the exclusion applies.

 

Definitions

Term

Definition

Estate Recovery

Legal claim against the estate of an ALTCS customer to recover amounts paid by AHCCCS on behalf of the customer.

 

Proof

Proof includes:

 

Legal Authority

Program

Legal Authority

ALTCS

42 USC 1396p(b)(1)(C)