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1153 Chapter 7:Worker guides • Section 7: OSIPM worker guides (07/2026) the type of trust you are reviewing and specific questions or concerns that are not addressed in OAR 461-145- 0540, the Treatment of Trusts for OSIPM Flowchart, or Complete Trust Guide for OSIPM. Most questions should be able to be answered by reviewing these resources. Long-term care insurance This worker guide covers the treatment of long-care term care (LTC) insurance for ongoing individuals and the treatment of resources for an applicant who has utilized LTC insurance purchased through the LTC insurance partnership (a qualified partnership policy). Long-term care insurance The circumstances around LTC insurance payments vary greatly from insurance company to insurance company. Some policies start payment immediately upon placement and others must have a waiting period before payments begin. Policies pay different rates depending on the type of policy the individual has purchased and some types of care may not be covered. Policies most often pay by the day, resulting in payment amounts that vary from month to month. Most policies pay directly to the individual, while others pay directly to the facility. By signing the application, the individual has assigned their rights to medical insurance payments to ODHS|OHA, as required by 461-120-0315. When the individual is placed in a care setting covered by the individual’s LTC insurance policy, the worker must make sure the individual applies for all insurance payments. Be sure to inform the individual or the representative of the process for dealing with long term care insurance payments. Individuals who fail to obtain their LTC insurance payments and provide those payments either to ODHS|OHA or the facility (depending on the care setting as explained below) are not eligible for Medicaid. Long-term care insurance payments for home or community-based care placements For individuals in home or community-based care settings, it is acceptable for the LTC insurance payments to be made directly to the individual or their representative. However, the individual must turn the payment over to ODHS|OHA when it is received. ODHS|OHA receipts the payment in as a reimbursement of past assistance, per the procedure described in the ODHS Business Procedure Manual. The receipt code is 121. This code ensures that the payment will be credited against the individual’s estate claim. Send these payments to: Medical Payment Recovery Unit PO Box 14023 Salem, OR 97309 If allowed by the individual’s LTC insurance provider, the individual can designate ODHS|OHA as the payee for the LTC insurance payments. These checks should be made payable to the “Oregon Department of Human Services.” When ODHS|OHA is the payee, turning in the payments each month is not necessary, but completing the paperwork to get each payment issued is still required. Sometimes when LTC payments are paid directly to ODHS|OHA, the insurance carrier issues a 1099 in ODHS|OHA’s