The Wisconsin Long-Term Care Partnership Program is a partnership program between Medicaid and private long-term care insurers designed to encourage individuals to purchase private long-term care insurance. Wisconsin long-term care partnership policies are tax-eligible under federal law (a portion of premiums paid may be claimed as a tax deduction); provide policyholders with inflation protection; and most importantly, provide dollar-for-dollar asset protection in case the policyholder needs to apply for long-term Medicaid support. For every dollar a Wisconsin long-term care partnership policy pays in benefits, a dollar of assets can be protected from Medicaid spending requirements. While program participants may reside in an adult family nursing home, community residential facility, or assisted living facility, family care and partnership programs do not cover the cost of accommodation and meals. Family care is considered a claims program, which means that as long as an applicant meets the eligibility criteria, benefits will be received. However, the Partnership Program is not a claims program. This means that the state limits the number of people who can participate in the programs and when all the participants` places are filled, a waiting list is formed. At the time of writing, there was no waiting list. When people have assets across borders, trusts are an option.
Irrevocable funeral trusts are prepaid funeral and funeral expense trusts that Medicaid does not count as assets. Another option is Medicaid Asset Protection Trusts, which not only protects assets from Medicaid`s asset limit, but also preserves them as heirs by protecting them from Medicaid`s estate recovery program. There are many other options if the applicant has assets that exceed the limit. A variety of products are approved in Wisconsin for long-term care planning. These include traditional and partnership-certified plans, short-term policies, and asset-based “hybrid” policies. Often, the only difference between a so-called partnership policy and other long-term care insurance sold in a state is the amount and type of inflation protection required by the state. Some program participants may be required to pay a “share of the cost” for the services. Wisconsin participates in the long-term care partnership program at the federal and state levels, providing dollar-for-dollar asset protection to individuals with qualified LTC insurance policies.
High-quality care options are available nationwide and several insurance solutions are available. Most states have reciprocity with long-term care partnership programs in other states, including Wisconsin. That said, if you`re moving to or leaving Wisconsin, protecting your partnership`s assets will also follow. For more information about the Medicaid program, see www.medicaid.gov A factor that distinguishes a partnership policy from a non-partnership policy is mandatory age-appropriate inflation protection. This automatically increases your benefits to cope with the rising cost of care. The partnership policy must provide inflation protection as follows: • 60 years and under: automatic compound inflation • 61-75: any inflation protection (composite, simple) • 76 years and over: inflation protection is discretionary The inflation option or future purchase option offered by many airlines, also known as GPO or FPO, is not considered an inflation option under the partnership, unless you are 76 years of age or older, since this type of inflation protection is considered optional, since the insured may choose not to exercise it. Both programs offer a participant-focused option called Self-Sustainment (SDS), which allows program participants to manage their own service budget. This option gives program participants flexibility and choice of the long-term care services they need and who uses them. This means that instead of receiving services from the MCO`s network of licensed care providers, a program participant can hire their own caregiver.
Parents, including spouses and adult children, can be hired. A financial management services agency is available to take care of the financial aspects of employment responsibility, such as withholding tax and payments for caregivers. Family Care and Partnership participants receive their long-term care benefits through a single Medicaid health plan. For the partner program, dental, visionary and medical benefits such as hospitalizations, wellness appointments, X-rays and laboratory services, as well as prescription drugs are integrated into the plan. This includes both Medicaid and Medicare benefits for people who are “doubly eligible,” meaning they are eligible for both Medicaid and Medicare. To be clear, family care does not integrate medical services into the program, but the program helps coordinate medical care. An individual care plan determines the benefits and support a program participant receives. While the following list may not include all available long-term care services, the following home and community services are available. Through the partner program, program participants also receive benefits in vision, dentistry, medicine and prescription drugs.
Since the Partnership Program is not an eligibility program, there may be a waiting list for program benefits. However, at the time of writing, there was no waiting list. The goal of the Wisconsin Long-Term Care Insurance Partnership program is to make it meaningful to purchase shorter-term and more comprehensive long-term care insurance by linking these special partnership-called policies to Medicaid for those who continue to need care. While the Family Care Program is available nationally, the Partnership Program is not. Starting in August 2021, it will be available in the following counties: Waupaca, Outagamie, Calumet, Sauk, Columbia, Dodge, Washington, Ozaukee, Dane, Jefferson, Waukesha, Milwaukee, Racine and Kenosha. The state plans to expand the program in 2023 to include Fond du Lac, Manitowoc, Winnebago, Brown and Shawano counties. To see a map of the counties where the program serves, click here. Family care and partnership programs are designed for Wisconsin residents who are older (65 years and older) or younger (18-64 years) and who have a physical, developmental or mental disability. Persons with disabilities who register before the age of 65 may continue to receive exemptions after the age of 65.
For the Partnership Program, applicants must live in a geographic area where the program is offered. Other criteria follow for people aged 65 and over. The State of Wisconsin participates in the Long-Term Care Insurance Partnership Program at the federal and state levels. The program, which has been approved by law, allows states to adopt these programs so that families can better protect assets from the high cost of long-term care. Family and partnered health plans are provided by a Managed Care Organization (MCO). An MCO is essentially a private health care company. The MCO has a network of service providers and program participants receive services through these providers. The availability of MCOs varies by geographic region, although most counties offer multiple MCO options.
WI has a medically needy Medicaid program called the Medicaid Deductible Program for Medicaid applicants who have high medical costs relative to their income. Also known as the Expense Reduction Program, applicants are allowed to spend “excess” income on medical expenses and health care premiums such as Medicare Part B to meet the Medicaid income limit. The amount that must be “spent” for each six-month period can be considered a deductible. Once the “deductible” for the period is completed, Family Care/Partnership pays for care services and support. A partnership program is a collaboration or “partnership” between a state government, private insurance companies that sell long-term care insurance in that state, and state residents who purchase long-term care partnership policies. Under a qualified partnership policy, personal assets equal to the total benefits paid are not included in the calculation of Medicaid eligibility. For every dollar of benefits paid, one dollar of assets does not count towards the eligibility limit. This means that you need to hold these assets and not spend them before qualifying for Medicaid. Reverse mortgages are available in Wisconsin. A reverse mortgage is a home equity loan where the borrower does not have to make payments. Because at least 70% of people over the age of 65 will need long-term care at some point in their lives.
And contrary to what many people believe, Medicare and Medicare don`t pay for the long-term care services that most people need. Wisconsin Partnership for Long-Term Care benefits include: • Daily or monthly benefits • Choice of elimination period or deductible • Full coverage, including home, adult daycare and residential coverage • Benefit period (money pool) • Discount There is a minimum income supplement set at $2,903.34/month (valid from July 2021 to June 2022), which is the monthly income of a non-applicant spouse at that amount. There is also a maximum income supplement of $3,259.50 per month (valid from January 2021 to December 2021) and depends on the cost of accommodation and utilities of the non-applicant spouse. This monthly alimony is intended to ensure that the non-applicant spouse does not become impoverished. Income The income limit for applicants for 2021, which increases each year in January, is $2,382 per month. If both spouses are applicants, each spouse is considered individually, with each spouse receiving a maximum income of $2,382/month. .