Home | Your Other Benefits | Long-Term Care
Long-Term Care Insurance
Qualified employees, their eligible dependents (spouse and children ages 18 through 25), retirees, parents and parents-in-law are eligible to apply for enrollment in long-term care coverage through MedAmerica.
- Covers certain services required by individuals who are no longer able to care for themselves without the assistance of others.
- Apply at any time, subject to medical underwriting (answering questions about your health). Employees who apply within 90 days of hire are not subject to medical underwriting. Call MedAmerica at 866.615.5824 or refer to their website for enrollment information.
- Covered services include nursing home care, assisted living, home health care, home care and adult day care.
- Benefits are available through different options based on a daily benefit amount ($100, $150 or $200) for either a three-year or five-year coverage period.
- Benefits are also available with or without inflation protection, which protects the value of the coverage you buy today to offset future increases in the costs for long-term care.
- You pay 100 percent of the premium.
- Premiums are based on age at the time of enrollment. The younger you are when you apply, the lower your monthly premium will be. View premium rates.
The insurance covers certain services required by individuals who are no longer able to care for themselves without the assistance of others. Natural aging, a serious illness or an accident may bring on this need.
Services covered include:
- Nursing home care
- Assisted living facility care
- Home care
- Adult day care
- Hospice program services
There are a number of fixed features in the plan:
- There is a 90-day elimination period that must be met — much like a deductible — by having a person qualify for services before the insurance coverage begins to pay for those services.
- The plan covers respite care, providing care for up to 21 days per calendar year at home or in a facility to give the primary caregiver a rest.
- Bed reservation is also covered for up to 21 days per calendar year to hold your bed in an assisted living facility, nursing home or hospice facility if you have to go to the hospital.
- The plan also covers home health agency services for household tasks that do not require a trained home health aide.
The plan is guaranteed renewable, which means it can never be canceled as long as you pay your premium. The coverage is portable, so you may continue to pay premiums directly to the insurance company under the same terms and conditions as active employees if you leave employment. The plan includes a waiver of premium so that if you qualify for benefits and satisfy the 90-day period, you can stop payment of premium and the coverage will remain in effect.
State and higher education employees and retirees are eligible to apply for optional long-term care coverage at any time. This coverage is also available to local education and local government employees (if offered by your agency). Local education and local government retirees are also eligible for coverage if receiving a benefit from TCRS or an optional retirement plan.