គោលនយោបាយភាពជាដៃគូ
ភាពជាដៃគូរដ្ឋកាលីហ្វ័រញ៉ាសម្រាប់ការថែទាំរយៈពេលវែង
តើខ្ញុំទទួលបានគោលការណ៍ភាពជាដៃគូដោយរបៀបណា?
គោលនយោបាយដែលអនុម័តដោយភាពជាដៃគូទាំងអស់គឺតម្រូវឱ្យមានការការពារជាក់លាក់ដើម្បីធានាឱ្យអ្នកនូវគោលនយោបាយគុណភាពដែលបំពេញតាមតម្រូវការរបស់អ្នក។ ទាំងនេះរួមមាន:
- 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.
- ការការពារទ្រព្យសម្បត្តិ
- 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.
- ការអនុវត្ត និងការត្រួតពិនិត្យការថែទាំ ៖ បន្ថែមពីលើការបំពេញការវាយតម្លៃដ៏ទូលំទូលាយ និងផែនការថែទាំ អ្នកសម្របសម្រួលការថែទាំក៏អាចទាក់ទងអ្នកថែទាំ និងរៀបចំឱ្យពួកគេនៅក្នុងផ្ទះដើម្បីផ្តល់ការថែទាំតាមពេលវេលាដែលត្រូវការ ចរចាអត្រាការប្រាក់ និងតាមដានគុណភាពនៃសេវាកម្មដែលបានផ្តល់ ប្រសិនបើចង់បានដោយអ្នកកាន់គោលនយោបាយ។
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.
តើគោលការណ៍ភាពជាដៃគូមានតម្លៃប៉ុន្មាន?
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.
តើខ្ញុំទទួលបានការធានារ៉ាប់រងភាពជាដៃគូដោយរបៀបណា?
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.
គោលការណ៍ធានារ៉ាប់រងថែទាំរយៈពេលវែងនៃភាពជាដៃគូត្រូវបានលក់តែដោយអ្នកជំនាញធានារ៉ាប់រងដែលមានអាជ្ញាប័ណ្ណដែលបានបញ្ចប់ការបណ្តុះបណ្តាលពិសេសដែលតម្រូវដោយរដ្ឋកាលីហ្វ័រញ៉ា។ គោលការណ៍ភាពជាដៃគូ ជាមួយនឹងមុខងារការពារទ្រព្យសម្បត្តិពេញមួយជីវិតរបស់វា ធានាថាអ្នកនឹងមិនត្រូវបានបង្ខំឱ្យចំណាយអ្វីគ្រប់យ៉ាងដែលអ្នកបានធ្វើការលើការថែទាំរយៈពេលវែងនោះទេ។
ទទួលយកការងារស្មានចេញពីគោលការណ៍គុណភាពខ្ពស់
គោលនយោបាយភាពជាដៃគូមានពីរប្រភេទ៖
- គោលនយោបាយសម្រាប់តែកន្លែងថែទាំដែលគ្របដណ្តប់លើការថែទាំនៅក្នុងកន្លែង (មណ្ឌលថែទាំ និងកន្លែងថែទាំលំនៅដ្ឋាន) ឬ
- គោលនយោបាយដ៏ទូលំទូលាយមួយដែលគ្របដណ្តប់លើការថែទាំនៅផ្ទះ ក្នុងសហគមន៍ ក៏ដូចជានៅក្នុងមណ្ឌលថែទាំ និងកន្លែងថែទាំលំនៅដ្ឋាន។
អ្នកជ្រើសរើសចំនួននៃការគ្របដណ្តប់ដែលអ្នកចង់បាន។ គោលនយោបាយផ្តល់ការធានារ៉ាប់រងពីមួយទៅប្រាំឆ្នាំ ឬពេញមួយជីវិត។ ដើម្បីធានាថាអ្នកកំពុងជ្រើសរើសការធានារ៉ាប់រងគុណភាពខ្ពស់ គោលការណ៍ភាពជាដៃគូទាំងអស់រួមមាន:
- ការការពារអតិផរណាដោយស្វ័យប្រវត្តិ ដើម្បីធានាថាអត្ថប្រយោជន៍របស់អ្នករក្សាល្បឿនជាមួយនឹងការកើនឡើងនៃថ្លៃថែទាំ។
- ការកាត់កងដែលត្រូវតែជួបតែម្តងគត់ក្នុងជីវិតរបស់អ្នក;
- ការសម្របសម្រួលការថែទាំដើម្បីជួយអ្នកក្នុងការរៀបចំផែនការ និងធានាសេវាកម្មដែលអ្នកចង់បាន និងត្រូវការ។
- ការលះបង់បុព្វលាភរ៉ាប់រង ខណៈពេលដែលអ្នកទទួលបានការថែទាំនៅក្នុងមណ្ឌលថែទាំ ឬកន្លែងថែទាំលំនៅដ្ឋាន។ និង
- អត្ថប្រយោជន៍គោលនយោបាយដែលអាចផ្លាស់ប្តូរបាន ដូច្នេះការថែទាំអាចត្រូវបានប្ដូរតាមបំណងដើម្បីបំពេញតម្រូវការបុគ្គលរបស់អ្នក។