Federal long term care benefits can be confusing, but the resources below will help. If you are a family member or caregiver for an individual who is looking to get federal long-term care benefits, this post will serve as a helpful guide. We’ll discuss the basics of Federal Long Term Care Insurance and how it works as well as what options you may have if you need to apply.
What is Federal long term care program (FLTCIP)?
The Federal Long Term Care Insurance Program (FLTCIP) is a program designed to help those who are elderly and disabled with the high costs of care. FLTCIP provides access to long-term care insurance protection, including cash benefits for home health services, adult daycare, inpatient hospitalization, respite care and more. The program was created by Congress in 1988 as part of an effort to encourage individuals who were eligible for Medicare Part A but not enrolled into enrollment at that time.
What does this mean?
If someone is already covered under Medicare they will need additional coverage such as Social Security Disability Income or some other form of supplementary income if they want federal long term care benefits .
What types of policies can I apply for?
There are four types of policies available through the FLTCIP program: individual, couple, family and pooled. The type that each applicant chooses will depend on their needs. For example, if someone is looking to apply as an individual they can choose from a basic policy or one with more extensive coverage options such as nursing home care costs not covered by Medicare and in-home health care services.
Do I have to enroll in Medicare Part A before applying for federal long term care benefits?
If you’re already enrolled under Part A when you take out your federal long term insurance plan then no additional action is required . This enrollment must be active at the time of application (you cannot be suspended) but it doesn’t need to be the same enrollment number.
If you’re not enrolled under Part A at the time of application then you’ll need to enroll before your federal long term care benefits are effective
How much does FLTCIP cost?
The premiums for a basic policy can range from $487 per year (for individuals) to over $600 per month (for couples). This will vary depending on factors such as age, where someone lives and how many people in their family or group plan they apply with . Keep in mind that if someone has had any gaps in coverage within the past five years, there may also be an increase in premium rates. Premiums can change each year so make sure to visit our website periodically for up-to-date information!
Please see the 2 cases below, you can check your premium in the tool here.
How does Federal Long Term Care Program (FLTCIP) work?
FLTCIP is a life-long contract that provides cash benefits to those who are elderly and disabled for long term care needs. There are three levels of coverage available: basic, standard and enhanced . With all policies, the age requirement must be met (65 or older) before any coverage can go into effect.
Basic Policy – This policy has no pre-existing condition limitations but does not provide as much protection as other plans do. Basic FLTCIP pays up to $180 per day with an annual limit of $3600 in home health services; it also covers adult daycare, respite care and inpatient hospitalization costs if they’re covered by Medicare Part A
Standard Policy – The Standard policy offers more comprehensive coverage options. It offers up to $750 per day in home health service coverage with an annual limit of $60,000; it also covers adult daycare and respite care costs if they’re covered by Medicare Part A.
Enhanced Policy – The Enhanced policy is the most comprehensive option and provides more extensive protection for those who are elderly or disabled. This plan pays up to $1600 per day in home health services (with a maximum of 120 days) as well as providing nursing home coverage which other policies do not cover. Additionally, this policy includes hospice benefits that will help pay for medications .
What can I do if I need long-term care?
There are many different ways you may be eligible for federal long term care benefit programs. For example, if you qualify for Social Security Disability Income (SSDI) then it is likely that you will also be eligible to apply for the Federal Long Term Care Insurance Program.
Some of the factors which may make a person ineligible are: being enrolled in Medicare Part B/C; having any pre-existing conditions or limitations on coverage and living outside of their home state at time of application.
The U.S government has designated certain companies as “Qualified Administrators” and they administer your benefits for you – this includes paying for premiums, deductibles, and co-payments.
Applying to Federal Long Term Care (FLTCIP)
To apply you’ll need: your Social Security number, date of birth, address (street, city, state) and zip code; citizenship status; contact information such as phone numbers and email ids – these will not go into effect until the application is accepted so it’s best to use personal emails rather than work/school ones). If married then both spouses should provide this info too. You can also download an application form from our website that includes instructions on how to fill out all sections correctly!
What happens after my FLTCIP acceptance?
Once accepted, you’ll begin receiving benefits. You will be assigned a Qualified Administrator and this company is responsible for paying your premiums as well as deductibles and co-payments (if they apply). Contact your qualified administrator if there are any changes in income or family status that may affect eligibility for the policy .
Remember to keep all documentation including proof of disability or age needed to qualify; copies of birth certificates, marriage certificate etc – it can’t hurt! If applying for coverage outside the home state then make sure to have application signed by an individual authorized to act on behalf of applicant’s legal guardian. All documents should be provided at time of application.
The Federal Long Term Care Insurance Program allows people who meet specified requirements such as being of a certain age or having disabilities to have access to federal long-term care benefits. If you are disabled and cannot work due to your disability then you may be qualified for Social Security Disability Income (SSDI) – this is what most people qualify for but there are other ways too.
If the applicant meets requirements, their Qualified Administrator will pay premiums, deductibles and co-payments on behalf of the individual. The application process can take up to 45 days and documents should include proof that one qualifies as well as copies of birth certificates etc if applying from outside your state
The Federal Long Term Care Insurance Program offers two levels of coverage: standard and enhanced policies . The Standard Policy has more limited coverage while the Enhanced policy offers more benefits such as adult day services and respite care.
The Federal Long Term Care Insurance Program is also sometimes referred to as the “Federal Elderly, Disabled or Handicapped Act” (FEDHDA). Remember that you need to be at least 18 years old when applying for this program; if married then both spouses must apply together.
Is Federal Long Term Care Insurance Program FLTCIP worth it?
This is a question that doesn’t have one answer – it all depends. It’s worth speaking with qualified financial advisors, possibly even social workers and others who deal in this area. Remember when looking at the rates to keep an eye out for premiums as well as deductibles and co-payments which may be required on top of paying your monthly premium
Once coverage begins, beneficiaries are eligible for long term care services such as nursing homes and hospice.
You’ll want to speak with a qualified financial advisor who specializes in this area – they can help you figure out if the Federal Long Term Care Insurance Program is worth it for your needs!
Who is eligible for Federal long term care?
The Federal Long Term Care Insurance Program (FLTCIP) is available to eligible federal and U.S. Postal Service employees and annuitants, active and retired uniformed service members, and certain qualified relatives.
Federal employees are eligible for the Federal Employees Health Benefits (FEHB) Program, which is for people who have jobs with the government.
Active uniformed service members
People on active duty, full-time National Guard duty for more than 30 days. This does not include people in the Individual Ready Reserve.
U.S. Postal Service employees
If you work for the U.S. Postal Service, and are eligible for the FEHB Program (whether or not you enroll).
Other people who are eligible to buy a house in Tennessee Valley Authority, D.C. Government, D.C. Courts, Commander Navy Installations (CNIC) and Nonappropriated funds employees of the U.S. Department of the Army, U.S Marine Corps (USMC), Navy Exchange Service Command (NEXCOM), Army and Air Force Exchange Service (AAFES), and U.S Air Force (USAF).
Federal retirees that retired on an immediate annuity or for disability and who are recipients of the Civil Service Retirement System (CSRS), Federal Employees Retirement System (FERS), or other retirement system.
Retired uniformed service members
You are eligible for federal long term care insurance if:
– you’re retired from the uniformed services and entitled to retired or retainer pay. This includes gray area reservists, even if you’re not yet receiving your retired pay.
U.S. Postal Service annuitants
Retired annuitants of the U.S. Postal Service who retired on an immediate annuity or because they’re disabled under CSRS, FERS, and any other retirement system for federal government employees.
Survivors of federal employees and annuitants, active and retired uniformed service members (SBPs, DICs considered as a survivor annuity)
Other eligible retirees
- Deferred annuitants
- Separated employees with title to a deferred annuity, even if you’re not yet receiving it
- Compensationers receiving compensation from the U.S. Department of Labor
- Tennessee Valley Authority annuitants
- D.C. Government annuitants first employed before October 1, 1987
- D.C. Courts annuitants
- Commander, Navy Installations (CNIC) retirees
- Nonappropriated funds (NAF) retirees of the U.S. Department of the Army, U.S. Marine Corps (USMC), Navy Exchange Service Command (NEXCOM), Army and Air Force Exchange Service (AAFES), and U.S. Air Force (USAF)
Spouses of eligible employees and retirees; former spouses are not eligible, even if they’re receiving a share of annuity payments.
Federal long-term care benefits are available to the spouses, children (18 years or older) – including adopted and stepchildren – of living eligible employees and retirees. Domestic partner children are considered stepchildren.
Domestic partners (either same-sex or opposite-sex) of eligible employees and retirees; you must submit a Declaration of Domestic Partnership form to the employee’s or retiree’s agency, annuity office, or branch of service before you apply.
Parents, parents-in-law, and stepparents
Parents, parents-in-law, and stepparents of living eligible employees; parents of retirees are not eligible.
Does FLTCIP cover spouse?
Yes. Spouses of eligible employees and retirees; former spouses are not eligible, even if they’re receiving a share of annuity payments. Domestic partners too are eligible.
What are the Benefits under FLTCIP program?
You can receive care at home or in an assisted living facility, nursing home, hospice, or adult day center. This coverage covers up to 100% of your daily benefits amount.
Benefits for international customers
You can receive care outside the United States up to 100% of your daily benefits amount.
Family caregivers and friends
Informal caregivers, such as family members and friends, can provide care at home up to 100% of your daily benefit amount. This is provided that the caregiver is not your spouse or domestic partner, and they didn’t live with your when you became eligible. Informal care provided by family members is covered up to 500 days.
Alternate care plan
If you have specific needs or are cost-effective, you may be eligible for customized benefits that do not fall under the FLTCIP.
Optional care that supports care at home include care planning visits, modifications to your home (such installing wheelchair ramps), medical emergency response systems, durable medical equipment (such a wheelchair, walkers, or hospital style beds), and home safety inspections. Your daily benefit amount can be up to 30x. The stay-at-home benefit also covers caregiver training, although it is only seven times your daily benefit amount. You can use this benefit at any time you are eligible, even during the waiting period.
As long as your premiums are paid on time, your coverage will not be cancelled. Your coverage cannot be cancelled due to changes in your health or your age.
Waiver of premium
After you have completed your waiting period, premiums are no longer due while you receive benefits.
FLTCIP provides benefits that provide temporary relief to your primary caregiver from their caregiving duties up to 30x your daily benefit amount per year.
Reservations for bed
The FLTCIP will cover actual costs incurred for bed reservations for those who are in assisted living facilities, nursing homes, or hospice facilities. This is up to 100% of the daily benefit amount for up to 60 calendar days.
Even if your eligibility group is no longer available (e.g., an employee who leaves government service), you can still keep your coverage so long as you pay the required premiums and you have not exhausted your maximum lifetime benefit.
No war exclusion
The FLTCIP coverage does not include a war exclusion, unlike many other long-term care insurance plans. Benefits may be payable for war-related conditions, whether declared or undeclared, as well as service in the armed forces and auxiliary units. There is no limit on the number of catastrophic events.
Premium stabilization feature
This feature is built in to decrease the need for future premium increases. This feature includes an adjustable amount, which is calculated as a percentage from premiums paid. This amount can be used to offset future premium payments, or to refund premium death benefits to your estate or designated beneficiary. It will not be modified more than once a year and will not exceed 100%.
Federal Long-Term Care Plans
Create a Plan
Long-term care insurance is not a one-size-fits all policy. To design a Federal Long Term Care Insurance Program (FLTCIP) plan that is best for you, first it’s important to understand the cost of care.
The next step is to make three important decisions:
Select a daily benefit amount
The daily benefit amount (DBA), is the maximum amount that we will pay for covered services per day. FLTCIP provides $100-$450 daily benefit amounts in increments of $50.
To help you choose a daily benefit amount, use the daily cost for care in your locality.
Choose a benefit period
If you receive benefits every day that are equal to your daily benefits amount, the benefit period is how long benefits will last. Your benefits will be longer if you are not receiving services or receive them less frequently than your daily benefit amount. FLTCIP provides benefits for 2, 3, and 5 years.
As a guideline, 70% people over 65 require long-term care. Women need more care (3.7 years) than men (2.2).
Inflation protection options available
Inflation protection ensures that your benefits are in line with rising costs and inflation. If inflation remains at 2.55%2 per year, the annual average cost of nursing home care will rise to $92,7103 in 20 years. To $153,405.
Two types of inflation protection are offered by the FLTCIP:
Option for Automatic Compound Inflation
The automatic compound inflation option (ACIO), which means that your daily benefit amount, maximum lifetime benefit, and premium will increase automatically by 3% each year, without any corresponding increases to your premium.
Future Purchase Option
Future purchase option (FPO), means that every two years, we will increase your daily benefit amount, and maximum lifetime benefit, based on the U.S. Department of Labor’s Consumer Price Index (CPI) for All Urban Consumers (CPI-U). Your premium will increase if you accept the offer. We will not offer you an increase in your coverage if you reject the offer more than three times.