Pennsylvania Long Term Care Insurance

The state of Pennsylvania has 12,802,503 residents, according to a census done July 2015. Individuals 65 years and above account for 17.0% of the total population. Females outnumber male residents (similar to other states) at 51.1%.

Senior residents in the state can receive care from 699 certified nursing homes in the state. Additionally, there are 88,117 beds available in these nursing facilities. The Medicare 5 Star Quality system has ranked nursing homes in the state as 43^rd nationally.

According to America’s Health Rankings, Pennsylvania has a low incidence rate when it comes to infectious diseases. However, the state has some difficulty dealing with its minimal per capita public health funding and high rate of drug-related deaths (from 15.1% to 18.7 deaths per 100,000 population). Additionally, Pennsylvania has high levels of air pollution.

Average Cost of Long Term Care Services in Pennsylvania

Costs (2016) for LTC services in Pennsylvania are as follows:

Home Health Aide (Daily Rate): $135

Nursing Home Care (Daily Rate, Semi-Private Room): $298

Nursing Home Care (Daily Rate, Private Room): $320

Assisted Living Facility (Monthly Rate, 1 Bedroom-Single Occupancy): $3,600

Pennsylvania Long Term Care Partnership Program

Pennsylvania has an approved state LTC partnership program. The program was approved by the U.S. Department of Health and Human Services last September 15, 2007. The state will honor partnership from other DRA (Deficit Reduction Act) partnership states.

What is a Long Term Care Partnership Program?

The partnership program is designed to encourage people to purchase long-term care insurance by providing a plan that will allow Medicaid to disregard some or all assets for Medicaid eligibility and estate recovery purposes. Through partnership plans, people will receive asset protection whenever policy benefits are exhausted and will need continued benefits through Medicaid.

Partnership qualified insurance policies allow their holders a much easier time of applying for Medicaid when their current policy benefits have run out. Instead of needing to reach below the asset threshold set by the federal health care program, policy owners can protect an amount of assets equal to their total benefits – allowing them to continue receiving care without the risk of losing their assets to Medicaid estate recovery procedures.

For insurance policies to be certified as Partnership policies in Pennsylvania, the Deficit Reduction Act of 2005 has set a number of requirements that must be met:

• Issue Date: The policy must be issued after the effective date of the Partnership Program in the state (September 15, 2007).
• State of Residence: The policy holder must be a resident in Pennsylvania at the time the coverage became effective.
• Inflation Protection: All Partnership policies must include inflation protection. Policies issued to individuals under age 61 must provide compound annual inflation protection. Policies sold to individuals who have attained age 61 but not yet attained age 76 must include some level of inflation protection. Inflation protection may be offered, but is not required to individuals who have attained age 76.
• Qualified under Federal Tax Law: All Partnership policies must adhere to the definition of a Long Term Care Insurance policy in section 7702B (b) of the Internal Revenue Code of 1986.
• Consumer Protection: The policy must adhere to the requirements defined in section 1917(b)(1)(C)(iii)(III) of the Social Security Act (42 U.S.C. section 1396p(b)(1)(C)(iii)(III).

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