Long Term Care

Pennsylvania Long Term Care Insurance Information & Statewide Costs

Pennsylvania has more than 12 million residents and 2 million of them belong to the 65 and older age bracket according to the 2011 records of the U. Census Bureau.The state’s senior population is expected to grow continuously in the succeeding years as 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. Below are the median costs of long term care services in key areas of the state.

Region Homemaker Services Hourly Rate
(Licensed)
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 - Easton $21 $21 $3,038 $259 $293
Altoona $16 $21 $2,415 $225 $258
Erie $18 $21 $3,015 $224 $240
Harrisburg - Carlisle $19 $21 $3,438 $232 $263
Johnstown $19 $21 $2,100 $198 $220
Lancaster $21 $21 $2,698 $256 $267
Lebanon $20 $21 $3,510 $244 $255
Philadelphia - Camden - Wilmington $20 $21 $4,245 $270 $300
Pittsburgh $20 $21 $2,438 $240 $249
Reading $20 $21 $3,283 $262 $294
Scranton - Wilkes-Barre $20 $21 $2,238 $225 $230
State College $19 $21 $3,349 $215 $248
Williamsport $15 $21 $3,165 $214 $242
York - Hanover $19 $21 $4,150 $254 $274
Rest of State $19 $21 $2,383 $185 $199

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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.

Long Term Care in Philadelphia

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 the Pennsylvania Insurance Department. The program aims to address the increasing demands for Long Term Care while relieving the growing financial burden on Medicaid. Studies reveal that Pennsylvania’s total Medicaid spending for fiscal year 2010 has exceeded $18 billion attributing 36.3% of this amount to Long Term Care expenses specifically those incurred in nursing homes (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.

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

Pittsburgh Long Term Care CostsPartnership 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.

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