Regulatory Bulletin 2009-05
Attachment C
STATE OF ARIZONA
LONG-TERM CARE INSURANCE PARTNERSHIP PROGRAM
POST-PURCHASE NOTICE
IMPORTANT NOTICE ABOUT YOUR LONG-TERM CARE INSURANCE PARTNERSHIP POLICY
Insurance Company Name: _________________________________________________________
Producer’s Name: _________________________________________________________________
Address: ________________________________________________________________________
Phone Number: ___________________________________________________________________
Email Address: ___________________________________________________________________
Policy No. _________________
Date of Notice _____________
Long-Term Care Partnership Policies
The State of Arizona has implemented a Long-Term Care Insurance Partnership Program (the
“Partnership Program”). that constitutes
a partnership between state government and private
insurance companies to assist Arizona residents in planning their long-term care needs.
Insurance companies voluntarily participate in the Program by offering long-term care
insurance policies (“Partnership Policies”) that meet special federal requirements.
As of the date of this Notice, the long-term care insurance policy identified above is a Partnership
Policy. As a result, if you apply in the future for long-term care coverage from Arizona’s Medicaid
program, your application will include a Medicaid eligibility feature known as "Asset Disregard".
“Asset Disregard” means that Medicaid will disregard some
of your assets in determining whether you
are eligible for Medicaid long term care coverage. The amount of assets that Medicaid can disregard
will be equal to the amount of long-term care insurance benefits you have received under your
Partnership Policy.
It is important to know that the purchase of a Partnership Policy does not automatically qualify
you for Medicaid. Me
dicaid has other eligibility criteria that may disqualify you. In addition, the
Asset Disregard rules may not apply to you if your home equity exceeds $500,000.
It also is important to know that your Partners
hip Policy may lose its Partnership status in the
future if:
a. You make a change to your Partnership Policy, including a change to the inflation
protection provisions, if any.
b. You move to a state that does not have a Partnership Program.
c. There is a change to state or federal law that governs the Partnership Program.
Additional Information
If you have questions regarding your long-term care insurance policy please contact the insurer. If you
have questions regarding current laws governing Medicaid eligibility or Asset Disregard, please
contact the Arizona Health Care Cost Containment System (“AHCCCS”).
LTCPP-AZ Attachment C
