Joint Oklahoma Information Network Oklahoma Health Care Authority

Consumer FAQs

Why do I need a long-term care plan? Doesn’t Medicare cover the cost of this service?
Many people think that Medicare will pay for any long-term care expenses, but actually Medicare only pays a small portion of the cost of long-term care. It pays for care in nursing facilities only when you meet certain criteria, and even then you are only covered for 20 days. A plan can help you evaluate the assets you want protected and choose protection you can afford.

What does Medicare cover for long-term care services?
Medicare is a federally funded program that provides health insurance for people who are 65 or older those with disabilities. It requires a three-day hospital stay before you can be transferred to a nursing home, and the services received must be related. And, if the needs change from skilled to custodial care, Medicare coverage ends.

What is the purpose of the OLTCP program, and how can it help me?
The OLTC P program helps Oklahomans prepare for their future by making long-term care policies available which may protect a portion of your assets. This “asset disregard” may help them should they apply for SoonerCare (Oklahoma Medicaid) once the benefits in their long-term care policy were depleted.

What is the cost of long-term care?
The average cost of a private room in an Oklahoma nursing home in 2007 was $132.85 each day (more than $48,000 per year).  Each year, those costs increase. An average length of stay is two and a half years.

What is long-term care?
Long-term care includes a variety of services that improve your quality of life and independence, such as assistance with bathing, dressing and other personal care needs. These services can occur in a nursing facility, an assisted living facility or even at a home. 

Why should anyone purchase an OLTCP policy?
Policies approved by the OLTCP program allow you to protect assets if you ever need to apply for SoonerCare (Oklahoma Medicaid). They also offer flexibility in where you receive your care, whether in a facility or your own home. Other long-term care policies do not include these features.

What does it mean to have a tax-qualified partnership policy?
With a tax-qualified policy, federal law allows you to claim some of the premium as a medical deduction, and the benefits of these policies are not taxable.

What is an example of how a partnership policy can help me?
Assume that you buy a partnership policy that provides $100,000 in benefits and you receive benefits of $100, 00 for the policy for your long term care expenses.  When you apply for SoonerCare, they will disregard $100,000 of those assets when determining your eligibility for the program.  Note that Sooner Care’s income guidelines will still apply.
     
How can I get more information about SoonerCare services?
To find out more about SoonerCare benefits and services, please call the SoonerCare Helpline at 1-800-987-7767 or go to the Web site at www.okhca.org. For information about SoonerCare eligibility, contact the Oklahoma Department of Human Services (OKDHS) at (405) 521-3646 or go the Web site at www.okdhs.org.

How can I get a free planning kit?
Contact the National Clearinghouse for Long-Term Care Information at www.longtermcare.gov or call 1-866-752-6582.

Who can I contact for details about long-term care insurance and a list of licensed certified agents?
Call the Oklahoma Insurance Department at 1-800-522-0071 (in-state only) or go to their Web site at www.ok.gov/oid/ for more information.