Types of Partnership Plans Available

The table below shows the five basic Partnership plans available. In the plan names, the ‘50' means that the home care or residential care facility minimum daily benefit amount is 50% of the nursing home minimum daily benefit amount. The ‘100' means that the home care or residential care facility minimum daily benefit amount is equal to the nursing home minimum daily benefit amount. In the event a person has continuing long-term care needs beyond the minimum duration of a plan, he/she may apply for Medicaid Extended Coverage (MEC) which allows for the disregard of all or some of his/her assets. The last row of the table shows the level of asset disregard for each plan. To learn more about MEC, click here: Medicaid & the Partnership

For a printable summary of the table, click here .

 

Total Asset 50

2/4/50

Total Asset 50

3/6/50

Total Asset 100

4/4/100

Dollar for Dollar 50

1.5/3/50

Dollar for Dollar 100

2/2/100

Nursing home coverage

2 years at a minimum daily benefit amount of $315 (2018)

3 years at a minimum daily benefit amount of $315 (2018)

4 years at a minimum daily benefit amount of $315 (2018)

1.5 years at a minimum daily benefit amount of $315 (2018)

2 years at a minimum daily benefit amount of $315 (2018)

 

or

Home care coverage

4 years at a minimum daily benefit amount of $157 (2018)

6 years at a minimum daily benefit amount of $157 (2018)

4 years at a minimum daily benefit amount of $304 (2018)

3 years at a minimum daily benefit amount of $157 (2018)

2 years at a minimum daily benefit amount of $304 (2018)

 

or

Residential care facility coverage

4 years at a minimum daily benefit amount of $157 (2018)

6 years at minimum daily benefit amount of $157 (2018) (at a minimum, includes home care services received in an assisted living residence)

4 years at a minimum daily benefit amount of $304 (2018)

3 years at minimum daily benefit amount of $157 (2018) (at a minimum, includes home care services received in an assisted living residence)

2 years at a minimum daily benefit amount of $304 (2018)

 

In the event both nursing home coverage & home care or residential care facility coverage are used, 2 home care/residential care facility days equal 1 nursing home day for the purpose of meeting Partnership utilization requirements.

In the event both nursing home coverage & home care coverage are used, 2 home care days equal 1 nursing home day for the purpose of meeting Partnership utilization requirements.

 

In the event both nursing home coverage & home care coverage are used, 2 home care days equal 1 nursing home day for the purpose of meeting Partnership utilization requirements.

 

Maximum daily benefit amount

None

None

None

None

None

Maximum plan duration

None

None

None

2.5 years of nursing home coverage & 5 years of home care coverage

3 years of nursing home coverage & 3 years of home care coverage & 3 years of residential care facility coverage

Elimination period (Sometimes this period is defined as the waiting or deductible period.)

No greater than 100 days

No greater than 100 days

No greater than 100 days

No greater than 60 days

No greater than 60 days

Other Basic coverage (shared by all plans)

•  3.5% or 5% annual compounded inflation protection required at purchase ages 79 and younger

•  Care management services

•  14 days of respite care per year

•  Nursing home bed reservation, 20 days per year

•  60 day grace period to ensure the premium is paid if you have designated someone to be notified when you fail to pay your premium on time

•  Hospice care

•  Coverage of alternate level of care status in a hospital while awaiting nursing home placement or at-home services

•  Review of denied benefit authorization requests

•  Guaranteed renewable

•  Level premiums (individual policy premiums cannot be raised, but premium rates on a class basis may be raised with the approval of the New York State Department of Financial Services when the solvency of the class of policies is in question)

•  Portability—coverage under the private insurance can be used outside New York State

Optional permissible coverage

•  Waiver of premium

•  Independent provider

•  Combined home and community-based care

 

•  Greater benefit standards than basic policy coverage

•  Waiver of premium

•  Combined home and community-based care

•  Independent provider

 

•  Greater benefit standards than basic policy coverage

•  Waiver of premium

•  Independent provider

•  Non-licensed/non-certified Provider or Non-licensed/non-certified caregiver

•  Combined home and community-based care

•  Permissible alternative benefits

•  Waiver of premium

•  Independent provider

•  Combined home and community-based care

•  Waiver of premium

•  Independent provider

•  Non-licensed/non-certified provider or non-licensed/non-certified caregiver

•  Combined home and community-based care

•  Permissible alternative benefits

Asset protection if meet the minimum duration requirement of policy & apply for MEC

Total

Total

Total

Partial depending on the amount of benefit paid

Partial depending on the amount of benefit paid