Pennsylvania Long Term Care Insurance Information & Statewide Costs
Pennsylvania has more than 12 million residents (2008 estimate) and is continuously growing. Residents are living longer, resulting in a growing need for healthcare services, especially Long Term Care - when they are no longer able to perform normal daily activities. Genworth Financial, a leading global insurance company conducted a statewide study on the cost of care in Pennsylvania.
| Region | 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) |
| Allentown-Bethlehem | $41 | $3,165 | $249 | $308 |
| Harrisburg-Lebanon | $50 | $2,755 | $231 | $246 |
| Lancaster | $51 | $2,970 | $223 | $259 |
| Philadelphia | $69 | $3,575 | $241 | $255 |
| Pittsburgh | $47 | $2,225 | $228 | $250 |
| Scranton/Wilkes-Barre | $49 | $2,163 | $215 | $224 |
| Rest of State | $49 | $2,357 | $199 | $213 |
Compare the Top Providers
Pennsylvania residents can compare the top 8 providers of long term care insurance in the state to get the best price.
More than 200,000 senior Pennsylvanians are enrolled in the State's medical assistance program known as Medicaid. However, Medicaid will pay for your Long Term Care needs only when your assets and resources (excluding your home and car) are less than $2,400. If you do not have private insurance, you will then have to pay for your expenses out-of-pocket and spend-down to Medicaid's asset limit in order to qualify.
Thus, considering private insurance is critical as one makes plans not only for their future. The good news is that there are more options now. In July 17, 2007, Act 40 was signed into law, establishing the Pennsylvania Long Term Care Partnership.
Pennsylvania Long Term Care Insurance Partnership Program
The Pennsylvania Long Term Care Partnership is a partnership program between private insurance companies and the State, through Pennsylvania Insurance Department. The program aims to address the increasing demands of Long Term Care while relieving the growing financial burden on Medicaid. Studies reveal that total Medicaid spending for fiscal year 2007 has amounted to almost $16 billion, where 40.2% of the total spending was devoted to Long Term Care, mainly for nursing home care expenses (almost $4 billion).
Long Term Care Partnership Policy
Policies that meet the requirements of the Partnership program are called Partnership policies and provide a unique feature called dollar-for-dollar asset protection. This provides the policyholder an asset protection equal to the insurance benefits paid by the policy. Therefore, if the policyholder received $200,000 of insurance benefits and still need Long Term Care, he is entitled to keep $200,000 in assets beyond the limit of Medicaid. This means that residents of Pennsylvania may continue to receive care through the Medicaid program without being required to spend down their assets, after depleting the benefits of qualified private insurance policies.
- Dollar-for-dollar asset protection
- Inflation protection - You purchase an insurance policy at a younger age (the younger the age, the better are the chances of approval, and the lower are the premium rates) and will not be needing coverage until sometime in the future. Inflation protection increases insurance benefits over time to allow for differences in costs of care. due to inflation. In order for a policy to qualify for the Partnership program, purchase of inflation protection is required for individuals under age 76. On the other hand, inflation protection is optional to those over 76 years of age.
- Partnership policies are tax-qualified - A tax-qualified policy allows you to claim a portion of the premium paid as tax deduction, provided your medical and dental expenses exceed 7.5% of your adjusted gross income. In addition to this, the insurance benefits received may not be taxable.
- Comprehensive coverage - As of July 17, 2007, all Long Term Care insurance policies provide a comprehensive coverage that includes skilled nursing care (round-the-clock services provided by skilled medical personnel i.e. a registered nurse or physical therapist), intermediate care (services provided by skilled medical personnel, but not required round-the-clock), custodial care (personal needs like eating, bathing, dressing, taking medicines, etc. that may be provided by non-medical personnel) and home health care (care received at home, provided by home health aides, homemakers, chore workers, or part-time skilled medical personnel).
Although Long Term Care policies provide a coverage that is comprehensive in nature, Partnership policies may cover all or just some of the expenses for long term care. Thus, it is still important to know the benefits and exclusions included in the policy before making a purchase.
Obtaining a Partnership Policy in Pennsylvania
Partnership policies may only be obtained from licensed insurance agents that have met specific set by the Partnership. The Partnership program is relatively new in Pennsylvania.
Meanwhile, it is best to start planning now. Some factors to consider are the type and level of care you need, and where you live. Eighty-one percent of Pennsylvania residents live in metropolitan areas where services are expected to be far more expensive. Financial advisers in Pennsylvania recommend that you own at least $75,000 of assets, outside your home or car, and at least $25,000 (or $35,000 for a couple) of annual retirement income.
Likewise, you may exchange your existing Long Term Care policy for a Partnership policy. You must inquire with your insurance company if your existing policy meets the requirements of a policy with Partnership coverage. Your policy must be purchased after February 8, 2006 and your insurance company must make you an offer to exchange.
Pennsylvania Long Term Care Insurance Rerefences
- Long-Term Care Partnership Policies. 2008. Pennsylvania Insurance Department.
- Long-Term care Insurance Guide. 2008. Pennsylvania Insurance Department.
- An Overview of Long-Term Care Insurance. Insurance Facts for Pennsylvania Consumers. 2002. Pennsylvania Insurance Department.
- Genworth 2009 Cost of Care Survey. Genworth Financial.
- State Medicaid Fact Sheets 2006-2007>Pennsylvania. Kaiser Family Foundation.
- U.S. Census Bureau>Quickfacts>Pennsylvania.