Long-term plans
OPM unveiled new features of the long-term care insurance program this week.
Frank Titus wants the federal long-term care insurance program to be the biggest in the country. To meet that goal, the federal program will have to enroll more than 160,000 people. That's how many people are covered under the California Public Employees' Retirement System long-term care program.
Titus, who runs the federal program from the Office of Personnel Management, unveiled several features that may help him meet his goal at the kick-off event for the long-term care insurance open season on July 1. The open season runs until Dec. 31.
Titus announced four basic coverage options, a design-your-own-plan feature and coverage options for people with pre-existing conditions that disqualify them for normal coverage. He also said that anyone who enrolls in the federal program will have access to a "care coordinator," who will help them find long-term care services. Federal employees will be able to call on the care coordinator for help getting care for their parents, even if their parents don't get the long-term care insurance for themselves.
"This is the best value in long-term care insurance ever offered," said Paul Forte, CEO of Long-Term Care Partners, the contractor that will administer the long-term care program for OPM.
Through the insurance program, about 9 million federal employees, military personnel, retirees and their family members can get coverage for nursing home stays and other types of day-to-day care for chronic illnesses or disabilities. Such care is not normally covered under standard health insurance.
The government negotiated premiums for the program that Forte says are on average 15 to 20 percent below premiums available to individuals on the open market. The government won't pay a portion of the premiums, as it does for standard health insurance. Long-term care insurance has an array of coverage options, so federal employees may find programs on the open market that better fit their needs at lower prices. For example, many long-term care insurance programs offer discounts when spouses both sign up. The federal program does not offer such discounts. Four pre-packaged plans are available through the federal program, each of which kicks in after a waiting period of 90 days after a beneficiary starts receiving long-term care:
- Facilities 100. Covers nursing home care costs up to $100 a day for three years.
- Comprehensive 100. Covers nursing home care costs or at-home care costs up to $100 a day for three years.
- Comprehensive 150. Covers nursing home care costs or at-home care costs up to $150 a day for five years.
- Comprehensive 150+. Covers nursing home care costs or at-home care costs up to $150 a day for an unlimited period.
The combination of daily benefits amounts and benefits periods creates a pool of money available to beneficiaries. For example, someone who selected a daily benefit amount of $100 for three years would have $109,500 available to them for long-term care. If they only spent $50 a day on care, the insurance would cover them for six years.
The application for long-term care insurance includes several questions that could disqualify people from enrolling for the basic policies. For example, people with multiple sclerosis, muscular dystrophy, Parkinson's disease or schizophrenia are not eligible for such policies. But they can sign up for a policy that covers only nursing care facilities with longer waiting periods and higher premiums, which Long-Term Care Partners and OPM designed for people who are very likely to need long-term care.
People with the most severe medical conditions won't be able to get the high-risk option either. But anyone can sign up for the services-only package, which provides access to negotiated discounts with long-term care service providers as well as access to care coordinators.
"We're glad that we have something for everyone who applies for our product," Titus said.
Long-Term Care Partners' Web site, at LTCFeds.com, has extensive information on the federal plans, including a premium calculator. The site was getting heavy traffic on Monday when the open season started, Titus said.
During an early enrollment period this spring, about 16,000 people submitted applications for the long-term care insurance. Titus said that was an encouraging start toward his goal of making it the biggest program in the country. Another promising figure is the 850,000 people who have signed up for the program's newsletter, the "Get Smart About Your Future" bulletin, which is also available on the LTCFeds.com Web site in the resource library.