Page 38
The Indiana Long Term Care Program (ILTCP) is jointly administered by the Family and Social Services Administration and the Department of Insurance. An applicant/member and their spouse, who purchases a long-term care policy that is a qualifying policy under the ILTCP, as determined by the Department of Insurance, is allowed a special resource disregard in his Medicaid eligibility determination once policy benefits have been utilized. The amount of the disregard for the applicant and their spouse depends on the type of “asset protection” earned by the qualifying policy. There are two types of disregards depending on the policy: 1) total asset protection; and 2) dollar-for-dollar asset protection. The available policy disregard is in effect for the lifetime of the member and their spouse. Total Asset Protection is available to the individual who purchased a policy or certificate that includes a maximum benefit equal to or greater than the State-Set dollar amount in force on the original effective date of the policy (i.e., when there was a policy agreement). To view the State Set dollar amounts for certain years, please, see the Total Asset Chart here: http://www.in.gov/iltcp/2358.htm. Dollar-for-Dollar Protection is available when the individual does not have Total Asset Protection. The amount of the resource disregard is applicable up to the limit on the policy. Policy benefits are payable for long-term care services provided in a long-term care facility or in the home. Not all long-term care insurance policies qualify for this "asset protection". Workers must verify that a policy is qualified under the ILTCP. Insurance companies who sell qualified ILTCP policies are responsible for documenting the number of benefits paid on behalf of their clients. The first page of the policy will have boxed language stating the policy qualifies for Medicaid asset protection. The insurer must provide a quarterly report to the insured individual summarizing the amount of benefits paid during the quarter and cumulatively since benefits were first paid under the policy, as well as the amount of asset protection earned.33 When an insured individual applies for Medicaid, the insurance company is required to provide the client with a service summary report.34 This service summary is the required documentation that workers will need in order to verify that a policy is qualified under the ILTCP and the amount of the resource disregard to be applied in the Medicaid eligibility determination of an applicant/recipient.