Montana Code 53-6-803. Long-term care insurance partnerships authorized
53-6-803. Long-term care insurance partnerships authorized. (1) The commissioner and the department may in their discretion establish long-term care insurance partnerships as provided for in federal law under 42 U.S.C. § 1396p or if allowed by a waiver of federal law under section 1115 of Title XI of the Social Security Act, 42 U.S.C. § 1315.
Terms Used In Montana Code 53-6-803
- Certificate: means a certificate as defined in 33-22-1107. See Montana Code 53-6-802
- Commissioner: means the commissioner of insurance provided for in 2-15-1903. See Montana Code 53-6-802
- Department: means the department of public health and human services provided for in 2-15-2201. See Montana Code 53-6-802
- Dollar-for-dollar model: means a program in which the amount of resources that is disregarded in determining medical assistance eligibility for an individual is increased by $1 for each dollar paid by an insurer to an insured under the insured's long-term care insurance policy or certificate. See Montana Code 53-6-802
- Long-term care insurance: means an insurance policy or certificate that provides coverage for medically necessary services in a long-term care facility, as defined in 50-5-101, or in the insured's home. See Montana Code 53-6-802
- Policy: means a policy as defined in 33-22-1107. See Montana Code 53-6-802
- State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See Montana Code 1-1-201
(2)The department may in its discretion collaborate with private insurers to implement long-term care insurance partnerships that will allow individuals who have resources in excess of the resource limit for receipt of medical assistance under the Montana medicaid program to receive medical assistance benefits if those individuals are eligible for or require the level of care provided by a long-term care facility and meet the other program requirements in accordance with federal law or an approved waiver in order to facilitate the enrollment of persons into long-term care insurance plans.
(3)Under partnerships created pursuant to this section, individuals may qualify for special treatment of their resources if they purchase a long-term care insurance policy or certificate certified by the commissioner and the department as provided in 53-6-804 prior to becoming eligible for medical assistance benefits. The department may modify eligibility and other medicaid requirements by administrative rule as provided in 53-6-805 and as allowed by state and federal law to encourage individuals to maintain long-term care insurance.
(4)The long-term care insurance partnerships may in the department’s discretion be based on a dollar-for-dollar model or any other model that is cost-neutral.