Políticas de asociación
Asociación de California para el Cuidado a Largo Plazo
¿Cómo obtengo una póliza de asociación?
Se requiere que todas las pólizas aprobadas por la Asociación tengan ciertas protecciones para garantizarle una póliza de calidad que satisfaga sus necesidades. Entre ellas se encuentran:
- Inflation Protection – This protects the policyholder from covering the difference between what the insurance policy will pay, which is based on the costs of services when you purchased the policy and the actual cost of care when you need it. Every Partnership policy is required to have this protection, and the state highly recommends that you protect yourself by only purchasing a policy with inflation protection.
- Protección de activos
- Comprehensive Care Management – A process to assess, plan, coordinate, and monitor long-term care needs and services. Care management/care coordination takes an all-inclusive look at a person’s total needs and resources, and links that person to a full range of appropriate services, using all available funding (and informal) sources.
- Rate Increases Regulated by the California Partnership for Long-Term Care – Long Term Care is the care given to someone who can no longer perform activities of daily living.
Partnership policies have two unique features that make them especially attractive.
Care Management: The Partnership requires that a Care Management Provider Agency, approved by the State Department of Health Care Services and independent from the insurer, provide care coordination for Partnership policyholders.
Using a collaborative process, the care manager works with the policyholder, their family, and physician to complete a comprehensive assessment to determine the client’s needs and resources, and develop a detailed Plan of Care individualized to meet those needs.
- Plan of Care: In developing the plan of care, the care coordinator will consider the unique needs of the client and recommend alternatives for how those needs can best be met. It is likely that without the help of a care coordinator, a policyholder or their family would have no idea of where to find someone to provide the necessary care. Partnership regulations require the care coordinator to consider how the policy benefits can help meet the policyholder’s needs and how the needs might also be met through other sources, perhaps through community services or the client’s health coverage, etc. These other sources can help reduce the out-of-pocket expenses to the policyholder as well as help the policy benefits last as long as possible. The identification of other sources of care can be especially important for a person who has a policy designed to pay benefits for only one or two years. Furthermore, since the Partnership requires the care coordinator to live in and be familiar with the community in which the policyholder resides, he or she will have a good understanding of where the quality providers are.
- Implementación y Monitoreo de la Atención: Además de completar una evaluación integral y un plan de atención, el coordinador de la atención también puede comunicarse con los cuidadores y hacer arreglos para que estén en el hogar para brindar atención en los momentos requeridos, negociar las tasas de pago y monitorear la calidad de los servicios prestados, si así lo desea el titular de la póliza.
Lifetime Asset Protection: This feature assures that catastrophic long-term care expenses won’t reduce you to poverty even if you run out of insurance benefits. That’s something other long-term care insurance policies do not offer (long-term care policies are a specific type of insurance policy designed to offer financial support to pay for necessary long-term care services.)
Here is how this special feature works. When you need care, your Partnership-approved private long-term care insurance policy pays for your care in the same way other high-quality long-term care policies would, but unlike a traditional non-Partnership policy, each dollar your Partnership policy pays out in benefits entitles you to keep a dollar of your assets if you ever need to apply for Medi-Cal services.
For most of you, the benefits of a Partnership insurance policy will provide all the care you will ever need. But you won’t have to impoverish yourself if you run out of insurance benefits and still need care. You can apply to Medi-Cal for assistance in paying the costs of your continued care and not have to “spend down” your savings to the poverty level. Each dollar your Partnership policy pays in benefits for your care is protected against Medi-Cal “spend down” rules. You may have to apply a portion of your income toward the cost of your care, but the assets you protected by purchasing a Partnership policy remain yours, for you and your spouse’s use or to leave to loved ones.
¿Cuánto cuesta una póliza de asociación?
A Partnership policy costs about the same or slightly less than other policies that offer similar coverage. Each insurance company offering Partnership policies has its own premium rates. However, the younger you are when you purchase coverage, the less expensive your premium will be. That is a good reason to buy earlier.
Unlike other policies, Partnership policies include lifetime asset protection and access to Medi-Cal services should you ever need them – an invaluable added benefit at no extra cost. This added protection and peace of mind comes only with the purchase of a Partnership policy.
Because of the Partnership’s asset protection feature, you don’t have to worry that you may run out of insurance benefits and end up spending the savings that you hoped to protect by having to pay for ongoing care needs. The asset protection feature allows you to purchase policies with coverage equal to the amount of assets you want to protect, from approximately $47,000 up to your total assets, with the assurance that these assets are protected for life, no matter how extended or expensive your long-term care needs may be. Without a Partnership policy, you could only achieve lifetime asset protection by purchasing lifetime insurance coverage – something most people cannot afford.
¿Cómo obtengo la cobertura de la asociación?
Partnership long-term care insurance policies may only be sold by select insurance companies that meet the special standards established by the state. Here is a list of Partnership certified companies.
Las pólizas de seguro de cuidado a largo plazo de Partnership solo son comercializadas por profesionales de seguros con licencia que han completado la capacitación especial requerida por el estado de California. Una póliza de asociación, con su característica única de protección de activos de por vida, garantiza que no se verá obligado a gastar todo por lo que ha trabajado en atención a largo plazo.
Eliminar las conjeturas de una póliza de alta calidad
Hay dos tipos de pólizas de asociación disponibles:
- Una póliza solo para un centro que cubre la atención en un centro (hogar de ancianos y centros de atención residencial) o
- Una póliza integral que cubre la atención en el hogar, en la comunidad, así como en un hogar de ancianos y un centro de atención residencial.
Tú eliges la cantidad de cobertura que deseas. Las pólizas ofrecen cobertura de uno a cinco años o de por vida. Para estar seguro de que está seleccionando una cobertura de alta calidad, todas las pólizas de asociación incluyen:
- Protección automática contra la inflación para garantizar que sus beneficios se mantengan al día con el aumento del costo de la atención;
- Un deducible que debe cumplirse solo una vez en su vida;
- Coordinación de la atención para ayudarlo a planificar y asegurar los servicios que desea y necesita;
- Exención de primas mientras recibe atención en un hogar de ancianos o centro de atención residencial; y
- Beneficios de póliza intercambiables para que la atención se pueda personalizar para satisfacer sus necesidades individuales.