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NYPERL Plan Description
Your tax-qualified NYPERL Care Directions Premier and Care
Directions Premier New York State Partnerships plans
provide benefits for covered services in:
- Nursing facility
- Home health care agency
- Adult day care center
- Assisted living facility
- Hospital long-term care unit
- Hospice program
You have two plans to choose from:
Care Directions Premier
Care Directions Premier New York State partnership
A detailed
plan overview that compares the two plans (in PDF format) can be easily referenced and
downloaded.
Care Directions Premier is a state of the art long-term
care insurance policy with a defined array of features
that provides coverage anywhere in the world. Care Directions
Premier Partnership qualifies as long-term care insurance
coverage that is linked with the New York State Medicaid
program under the New York State Partnership for Long-Term Care.
Is one option better than the other? That depends on your
personal circumstances. Both options offer comprehensive
and excellent long-term care insurance coverage, but
their benefit packages are different. The care directions
premier option offers a 10-year paid in full option and
other options and benefits not available through the
partnership option.
The Care Directions Premier Partnership option complies
with the rules and guidelines of the New York State
Partnership for Long-Term Care program. These rules will
also apply to those who select the Care Directions Partnership
option. If you intend to live somewhere other than New York
state then the benefits of the partnership option are
greatly diminished and you should consider the non-partnership
option. If on the other hand you intend to spend the rest of
your life in New York State the partnership option is probably
the one you want to consider.
Since Care Directions Partnership coverage must meet the
requirements of the Partnership program, it provides a "bank
of days" comprised of 3 years (1,095 days) of nursing home
care, or 6 years (2,190 days) of home and community-based care,
or a combination of the two where 2 home care days equal 1
nursing home day. If an insured person with Partnership
coverage uses the benefits according to these time periods
and continues to need care, s/he can qualify for Medicaid
Extended Coverage based on income alone - all of the covered
person's resources, or assets, are ignored in determining
Medicaid eligibility. The Partnership program, administered
at the New York State Department of Health, refers to Partnership
coverage as "lifetime coverage" due to this link to Medicaid.
Enrollees selecting the Partnership option must sign a
Consumer Participation Agreement, required by the Partnership,
that officially enrolls them in the New York State Partnership
program. At the time of applying for Medicaid Extended Coverage,
an enrollee's income must qualify him for Medicaid Extended
Coverage eligibility, and his/her income is treated according
to Medicaid rules in effect at that time, though personal
assets are ignored by Medicaid and not required to be spent down.
For additional details, please download our
MedAmerica-NYPERL brochure; group outline of coverage for Care Directions Premier or Care Directions Premier New York State partnership and the national association of insurance commissioner's Shopper's Guide.
Benefits may vary by state.
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