Most people will need long-term care at some point in their lives, whether it be care provided by family members, or by home health aides in your home or in a facility. If you need to pay for care in the future, how will you cover the cost? If you have a low income and have spent down your assets, Medicaid (MaineCare) may pay for your care. If you have assets to protect, you may want to consider buying a long-term care policy or decide to pay for your own care, if and when it is needed, with your savings and assets.
Do I Need Long-Term Care Insurance and Can I Afford It?
The decision to buy long-term care (LTC) insurance is based on many factors, including your age, health, retirement goals, and income and assets. If your only source of income is Social Security, it may not make sense to purchase LTC insurance, as the cost is likely to be too expensive. You should only buy a policy if you are confident you can pay the premium and any rate increases that may be applied to the policy.
Do Your Homework and Be a Smart Shopper
Be sure to read the Bureau's Consumer Guide to Long-Term Care Insurance and Maine's Long-Term Care Partnership Program (PDF), which includes sample plans and rates, and review the other resources listed below. When shopping for a policy:
- Work with a reputable agent who is knowledgeable about long-term care insurance.
- Check with multiple companies to get personalized rate quotes.
- Ask the company for an Outline of Coverage before you buy.
- Make sure that you understand the benefits and the limitations of the policy.
- Ask the company about its history of rate increases.
Partnership Policies and MaineCare Eligibility
Sometimes people assume they will be able to use up their assets or give them to their children in order to qualify for Medicaid (MaineCare) long-term care assistance. MaineCare has restrictions that often makes this strategy impossible. A long-term care insurance policy that qualifies for the Partnership Program will provide increased protection from the income and asset spend-down required to qualify for MaineCare.
In determining your eligibility for MaineCare benefits, MaineCare will not take into account your assets equal to amounts paid out under a qualifying long-term insurance policy.
- For example, if you purchase a Partnership policy and it pays out $50,000 in benefits, MaineCare will disregard $50,000 of your assets when determining your eligibility for assistance with long-term care costs.
For information about MaineCare eligibility contact the Office of MaineCare Services (Department of Health & Human Services) at (207)-287-2674.
Talk with your agent about whether a Partnership Program policy is right for you. Only certain types of long-term care policies qualify for the Partnership Program and the state and federal laws governing the program are subject to change. The list of policies approved for use in Maine's Long-Term Care Partnership Program can be viewed online.
Protections to Know About, if You Choose to Buy
Free Look Period: Maine law requires that companies offer a 30 day free-look period for long-term care insurance. Take advantage of it! Read your policy, ask questions, and if you are not satisfied, return the policy for a refund. If you do decide to return the policy, hold on to the envelope your policy was mailed in, or ask your agent for a delivery receipt when they provide you with the contract. The date the policy is delivered is the start of the 30 day period.
Third Party Notice: When you apply for long-term care insurance, you will be offered the opportunity to name someone as a "third party" contact. This person will be contacted if your insurance coverage is at risk of being canceled for non-payment at some point.
Limited Protection From Insolvency: If your long-term care insurer is found to be insolvent, Maine’s guaranty associations provide protection up to $300,000 to Maine policy holders.
Complaints, Appeals and External Reviews: You have rights certain rights if you have a long-term care insurance claim denied. Learn about the complaint, appeal and external review processes.
- Consumer Guides for Long-Term Care Insurance
- Pending & Recent Rate Increases
- Tax Qualified Plans
- Long-Term Care FAQs
- Maine Life and Health Insurance Guaranty Association FAQs
Find more resources at the National Association of Insurance Commissioners