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Aged, Blind and Disabled Manual Policy Manual Number: 125.025 Section: Institutional Medicaid Chapter: Long-Term Care Partnership March 18, 2019 Division of TennCare 2 b. Asset Disregard When determining eligibility for TennCare Medicaid, TennCare shall disregard an individual’s assets in an amount equal to the amount of payments made by the individual’s qualifying LTC policy for services covered under the policy. TennCare Medicaid individuals will be required to submit written proof of benefits paid from their LTCP policies. c. Partnership Program Benefits An LTCP participant receives the following benefits during his lifetime: i. Assets may be disregarded in an amount equal to the benefits paid out by the qualified LTCP policy as of the effective date of the initial TennCare Medicaid approval; ii. Disregarded assets are not counted toward the TennCare Medicaid asset limit for eligibility purposes; and iii. Assets may be transferred to any other person without penalty. NOTE: Additional benefits paid by the qualified LTCP policy after initial TennCare Medicaid approval shall not be disregarded in future renewal or determination of TennCare Medicaid eligibility. d. LTCP and Estate Recovery After the LTCP/TennCare Medicaid enrollee is deceased: i. Assets which were disregarded during the TennCare Medicaid eligibility determination process because the enrollee purchased an LTCP policy are protected from estate recovery. ii. When the amount of assets disregarded during the TennCare Medicaid eligibility determination process are less than the total benefits paid by the LTCP policy, additional assets up to the total amount of payments made by the LTCP policy may be protected during the estate recovery process. 3. Individual Responsibilities It is the responsibility of the LTCP policyholder to inform TennCare that he has an LTCP policy. TennCare Medicaid is typically the payor of last resort. Enrollees with other health care coverage or who have another party liable for their medical expenses will have medical costs paid by those sources before TennCare pays claims. Enrollees are required to cooperate with providing information regarding other payment sources. This includes LTC and LTCP insurance. LTCP insurance benefits may not be used to offset the amount the enrollee is required to contribute, pursuant to federal post-eligibility provisions, to the cost of TennCare Medicaid reimbursed LTC services (known as “patient liability”), but rather, must be used to help offset the cost of LTC services that would otherwise be reimbursable by TennCare. Thus, both the LTC insurance benefits and patient liability reduce the TennCare payment for LTCP services.