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Wisconsin Long Term Care Insurance Information

Wisconsin has 5,771,337 residents, per a census conducted last July 2015. Individuals 65 years and above make up 15.6% of the total population. There are slightly more females than male residents in the state at 50.3%.
Majority of residents in Wisconsin are covered by insurance, according to America’s Health Rankings. A high number of binge drinkers and obesity are problems the state currently faces – 31.2% adults in the state are obese, 9.0%, as a result, are diagnosed with diabetes.
The state provides excellent skilled nursing home care services, which the Medicare 5 Star Quality rating system ranked Wisconsin 11th nationally. There are 388 certified nursing homes in the state that contain 33,728 beds to cater to the needs of senior residents.

Average Cost of Long Term Care Services in Wisconsin

Costs (2016) for LTC services in Wisconsin are as follows:
Home Health Aide (Daily Rate): $144
Nursing Home Care (Daily Rate, Semi-Private Room): $257
Nursing Home Care (Daily Rate, Private Room): $280
Assisted Living Facility (Monthly Rate, 1 Bedroom-Single Occupancy): $3,934

Wisconsin Long Term Care Partnership Program

Wisconsin has an approved state LTC partnership program. The program was approved by the U.S. Department of Health and Human Services last January 1, 2009. 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 Wisconsin, 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 (January 1, 2009).
  • State of Residence: The policy holder must be a resident in Wisconsin 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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