To encourage people to make better plans for their future long-term care needs and to protect the stability of the Medicaid program, CMS has announced a set of steps to keep coverage secure and improve care for people with Medicare and Medicaid. These policies include new incentives for people to buy private long-term care insurance, improved rules governing the transfer of assets to prevent inappropriate use of taxpayer-funded programs, and improved coordination of care for dual-eligibles who are in managed care plans.
Medicaid rules normally require applicants to have spent their assets before they qualify for Medicaid and its long-term care benefit. State Medicaid programs may disregard assets that match, dollar for dollar, the amount paid to an applicant by a private long-term care insurance policy when determining if the applicant meets the asset limits for Medicaid eligibility. Changes made by the Deficit Reduction Act will allow those same assets to later be deducted from the amount the state must recover from the beneficiary’s estate.
Under the new program, only individuals who purchase long-term care insurance policies that meet certain requirements will be eligible to protect assets from estate recovery. The DRA also provides protections to individuals who otherwise would be subject to periods of ineligibility, by strengthening the hardship waiver process.
CMS also announced steps to improve access to coverage in special needs plans that serve dual-eligible Medicare beneficiaries. Three guides provide clarification of Medicare and Medicaid rules that have created administrative difficulties for special needs plans and confusion for beneficiaries. CMS said it will soon issue a new policy that will allow plans to serve certain segments of the dual-eligibles, such as only the disabled or only the elderly.
