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Texas Long Term Care Insurance Information

Texas has 27,469,114 residents, according to census done last July 2015. Elder individuals 65 years and above make up 11.7% of the total population. Females, like other states, slightly outnumber male residents at 50.4%.

Based on information gathered by America’s Health Rankings, Texas faces the heavy problem of having majority of its residents being uninsured. Additionally, the disparity in health status and one’s educational level has increased (28.3% to 34.0%). Also, obesity has increased (29.2% to 31.9% of adults during the past two years). However, the state has managed to decrease the number of residents who smoke (18.2% to 14.5% for the last two years).

The state is ranked 51st nationally by the Medicare 5 Star Quality rating system when it comes to providing nursing home care services. There are 130,974 available beds in 1,223 certified nursing homes in the state to cater to senior residents.

Average Cost of Long Term Care Services in Texas

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

Home Health Aide (Daily Rate): $119

Nursing Home Care (Daily Rate, Semi-Private Room): $148

Nursing Home Care (Daily Rate, Private Room): $195

Assisted Living Facility (Monthly Rate, 1 Bedroom-Single Occupancy): $3,515

Texas Long Term Care Partnership Program

Texas has an approved state LTC partnership program. The program was approved by the U.S. Department of Health and Human Services last March 1, 2008. 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 Texas, 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 (March 1, 2008).
  • State of Residence: The policy holder must be a resident in Texas 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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