Mga Patakaran sa Pakikipagsosyo
Pagtutulungan ng California para sa Pangmatagalang Pangangalaga
Paano Ako Makakakuha ng Patakaran sa Pakikipagsosyo?
Ang lahat ng patakarang inaprubahan ng Partnership ay kinakailangang magkaroon ng ilang partikular na proteksyon para matiyak na may kalidad na patakaran na nakakatugon sa iyong mga pangangailangan. Kabilang dito ang:
- 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.
- Proteksyon ng Asset
- 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.
- Pagpapatupad at Pagsubaybay sa Pangangalaga: Bilang karagdagan sa pagkumpleto ng isang komprehensibong pagtatasa at plano ng pangangalaga, ang tagapag-ugnay ng pangangalaga ay maaari ding makipag-ugnayan sa mga tagapag-alaga at ayusin na sila ay nasa tahanan upang magbigay ng pangangalaga sa mga kinakailangang oras, makipag-ayos sa mga rate ng pagbabayad at subaybayan ang kalidad ng mga serbisyong ibinigay, kung nais ng may-ari ng patakaran.
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.
Magkano ang Gastos ng Patakaran sa Pakikipagsosyo?
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.
Paano Ako Makakakuha ng Saklaw ng Pakikipagsosyo?
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.
Ang mga patakaran sa seguro sa pangmatagalang pangangalaga sa pakikipagsosyo ay ibinebenta lamang ng mga lisensyadong propesyonal sa seguro na nakakumpleto ng espesyal na pagsasanay na kinakailangan ng estado ng California. Tinitiyak ng isang patakaran sa Pakikipagsosyo, kasama ang natatanging tampok na proteksyon ng asset na panghabambuhay, na hindi ka mapipilitang gastusin ang lahat ng pinaghirapan mo sa pangmatagalang pangangalaga.
Pagkuha ng Hula sa isang Patakaran sa De-kalidad na Patakaran
Mayroong dalawang uri ng mga patakaran sa Partnership na available:
- Isang pasilidad-lamang na patakaran na sumasaklaw sa pangangalaga sa isang pasilidad (nursing home at residential care facility) o
- Isang komprehensibong patakaran na sumasaklaw sa pangangalaga sa tahanan, sa komunidad, gayundin sa isang nursing home at pasilidad ng pangangalaga sa tirahan.
Pipiliin mo ang halaga ng coverage na gusto mo. Ang mga patakaran ay nag-aalok ng saklaw mula isa hanggang limang taon o habang-buhay. Upang makatiyak na pinipili mo ang mataas na kalidad na saklaw, kasama sa lahat ng patakaran ng Partnership ang:
- Awtomatikong proteksyon sa inflation upang matiyak na ang iyong mga benepisyo ay naaayon sa tumataas na halaga ng pangangalaga;
- Isang deductible na dapat matugunan nang isang beses lamang sa iyong buhay;
- Koordinasyon ng pangangalaga upang tulungan ka sa pagpaplano at pag-secure ng mga serbisyong gusto at kailangan mo;
- Pagwawaksi ng mga premium habang tumatanggap ka ng pangangalaga sa isang nursing home o pasilidad ng pangangalaga sa tirahan; at
- Mapapalitan ang mga benepisyo ng patakaran upang ma-customize ang pangangalaga upang matugunan ang iyong mga indibidwal na pangangailangan.