State RegulationsNY specificDifficulty 2/5
A New Yorker owns a Partnership-qualified long-term care policy, exhausts its benefits, and then applies for Medicaid to continue her nursing home care. Under Reg 144, how does the Partnership affect her Medicaid application?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under Reg 144 (11 NYCRR Part 39), the heart of the New York State Partnership for Long Term Care is asset disregard: when a Partnership policyholder exhausts the policy's benefits and turns to Medicaid, an amount of assets equal to the benefits the private policy has already paid is protected - disregarded - in the eligibility determination. The insured gets credit, dollar for dollar, for the care the private policy financed.
Why the other options are wrong
- A) Requiring a full spend-down would defeat the program's purpose; the benefits already paid by the policy shelter corresponding assets.
- B) Prior private coverage is the qualification for the protection, not a ground for denial.
- D) The policy benefits are not a debt owed to the state; the program's trade is asset protection in exchange for the private coverage that was purchased.
Memory hook
The policy paid for the care, so the same value of assets is shielded.