Long Term Care

Florida Long Term Care Insurance Cost & Partnership Information

According to a study conducted by Genworth, the cost of Long Term Care in Florida is rising faster than inflation. In Florida's four largest regions surveyed, the cost of a private room in a Nursing home has risen 5 percent in Jacksonville annually since 2005, 4 percent in the Tampa-St. Petersburg region and 3 percent in Miami-Fort Lauderdale and Orlando, respectively, compared to only a 2.3% rise in the core CPI in the same period.

The average annual rate of a private room in nursing homes in Florida would cost $84,552 while a semi-private room is about $78,475. The most expensive ones can be found in metro areas of Naples and West Palm Beach wherein average daily rates are $313 and $247, respectively. Assisted living facilities are also most expensive in Naples, costing residents about $4,500 a month. Below is the 2012 median cost of care data as provided by Genworth.

Region Homemaker Services Hourly Rate
Home Health Aide Hourly Rate
(Medicare Certified)
Assisted Living Facility Monthly Rate
(Private room)
Nursing Home Daily Rate
(Semi-private room)
Nursing Home Daily Rate
(Private room)
Daytona Beach-Ormond Beach $17 $18 $3,450 $216 $244
Fort Myers-Cape Coral $16 $18 $2,945 $190 $230
Fort Walton Beach $16 $19 $3,600 $190 $200
Gainesville $18 $20 $3,800 $195 $205
Jacksonville $18 $19 $3,350 $208 $226
Lakeland-Winter Haven $17 $19 $2,825 $220 $238
Melbourne-Titusville-Palm Bay $16 $18 $3,750 $217 $244
Miami-Fort Lauderdale-Pompano Beach-Boca Raton-West Palm Beach $16 $16 $2,125 $245 $265
Naples $21 $21 $4,500 $245 $289
Ocala $18 $18 $3,048 $215 $240
Orlando-Kissimmee $18 $19 $2,825 $215 $233
Palm Coast $17 $17 $2,675 $225 $230
Panama City-Lynn Haven $18 $19 $1,700 $201 $223
Pensacola-Ferry Pass-Brent $18 $20 $2,484 $200 $213
Punta Gorda $20 $20 $2,850 $240 $260
Sebastian-Vero Beach $18 $19 $3,145 $215 $230
Sarasota-Bradenton-Venice $20 $21 $2,948 $233 $225
Tallahassee $17 $18 $4,330 $200 $225
Tampa-St. Petersburg-Clearwater $18 $19 $2,775 $222 $236
Rest of State $19 $20 $2,000 n/a $215

In order to prepare for the rising costs of Long Term Care and to protect their assets, more and more Floridians are turning to private Long Term Care insurance.

Long Term Care Costs in West Palm Beach

Florida Long Term Care Insurance Partnership Program

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Long-Term Care Partnership Program has long existed since the 1980s but was introduced in the State of Florida only in 2005, when the Florida legislature passed a bill to provide the foundation for the establishment of a Partnership program. The Agency for Health Care Administration was also directed to draft a program that will lay out standards and eligibility, in coordination with the Office of Insurance Regulation. In 2006, lawmakers approved a senior protection bill "to make Long Term Care insurance affordable, available and marketable".

Florida Long Term Care Partnership Program is an insurance program wherein Medicaid and private insurance are used to fund Long Term Care for the people of Florida. Partnership policies will match dollar-to-dollar the assets which a policyholder wishes to protect.

For example, you purchase a Partnership-approved private insurance plan with $30,000 Long Term Care coverage. When the time comes that Long Term Care is needed, the policy will pay for Long Term Care costs up to $30,000. After using up the coverage and you still need care, you may apply for Medicaid assistance. However, Medicaid program in the State of Florida requires $2,000 of assets and resources to be eligible for assistance. There are stringent requirements and penalties for transferring assets in order to qualify.

But under the Partnership program, policyholders may keep the assets equal to the amount paid out by the private insurance policy. Therefore, $30,000 worth of assets may be kept for a $30,000 insurance plan. Medicaid will not count $30,000 in assets and still be eligible for Medicaid assistance. This Medicaid Eligible and Asset Disregard is an important feature of the Partnership program.

Florida Long Term Care Partnership Policies

Several Long Term Care policies are being offered by various insurance companies. Amidst the variety, there are certain provisions that must be included in Long Term Care insurance policies marketed in the State of Florida.

Florida Partnership LTCiLong Term Care policies must provide at least one lower level of care, aside from nursing care. Nursing care involves three types: skilled care (24-hour care for medical conditions, provided by trained medical personnel), intermediate care (services needed daily but does not require 24 hour care) and custodial care (also called personal care; assistance to be able to perform activities of daily living, i.e. eating, dressing, bathing, etc.).

Lower level of care, on the other hand, includes home health care or adult day care. Long Term Care policies must provide lower level of care equal to at least half of the benefits (benefit period and amount) of nursing care. Therefore, if your private insurance policy has two-year nursing care coverage, the policy must also cover at least one year of lower level of care. Long Term Care insurance policies cover expenses in two ways. One way is by paying the actual costs or expenses. These policies have a daily benefit amount which is the amount the policy pays out each day. Coverage may be limited to nursing home only or a combination of nursing home, and home or community-based care. The other method is by paying the insured a fixed-dollar amount, called indemnity for each day covered.

Indeed, benefits vary but Long Term Care insurance policies must satisfy minimum requirements to qualify in the Partnership program. These include:

In addition to the above features, all partnership policies contain a disclosure notice (Partnership Status Disclosure Notice) containing the asset disregard and explaining the benefits associated with policies that qualify as partnership policies. Insurance companies are also required to notify policyholders of the status of the policy and disclose what actions will lead to loss of partnership status (e.g. claimant modifies coverage after issue, changes in state or federal laws, etc). Policyholders are informed through writing the reasons for loss of status and are advised of ways to retain partnership status, if possible.

The State of Florida also has Long Term Care Partnership reciprocity, meaning a Partnership policy may be used in another state or a partnership policy purchased in another state be used in Florida, provided that the other state has reciprocal agreement with Florida when the coverage became effective. Also, it is important that Medicaid eligibility requirements of the state where you plan to relocate be determined. Remember that even if you are eligible for Medicaid benefits, you still need to apply to the state's Medicaid program.

Obtaining a Partnership Policy

Partnership policies can only be sold by agents who have completed Florida-specific training All insurance companies who market or sell Partnership policies must report to the Health and human Services Secretary as required by Centers for Medicare and Medicaid Services insurance benefits that have been paid.

Florida Long Term Care Insurance References