Your LTC Program is designed to protect you now–and well into the future. The Long Term Care Program offered to PERA members and retirees gives you options that enable you to customize your long term care protection in a variety of ways. Consider these standard features that place all of the decisions in your hands:

 

Your choice of daily benefit amounts of $100, $130 or $180.

Your choice of benefit periods: 3 years, 5 years or Lifetime maximums.

Your choice of elimination periods, either 60 or 90 days, providing more flexibility and cost management.

A unique "Pool of Dollars" approach that lets you decide how your long term care dollars are spent, making your benefits more flexible.

Daily benefits that compare favorably with current costs and likely levels of usage.

A choice of Tax-Qualified or Non-Tax-Qualified Programs, which gives you the option of how you access your long term care benefits. Click here for more information on the differences between these two types of programs.

Rate guarantees that ensure your rates won't change over time. The LTC Program offered to PERA members and retirees offers a 10-year rate guarantee for those less than 65 years of age at the time of application and a 5-year rate guarantee for those 65 and over.


In selecting the benefits you want, please note that the Nursing Home Benefit you choose determines the maximum daily benefit amount available to you for other benefits (e.g., Assisted Living Facility, Home Health Care, etc. and your Lifetime Maximum Benefit).

This is a brief description of benefits available. The information provided is intended only to assist in the selection of benefits. Final determination of benefits and exact terms and conditions are contained in the policies issued by the insurance company.

 

FEATURE

OPTIONS/DESCRIPTION
 
Nursing Home Benefit
 
$100/day

$130/day

$180/day
 
Benefit Period
 
3 years
5 years
Lifetime
 
Elimination Period
(Lifetime)

 
60 days
90 days
 
Tax Status
 
Tax-Qualified or Non-Tax-Qualified
 


Assisted Living Facility Benefit

 
Up to 100% of the Maximum Daily Benefit
 
Home Health Care Benefit
 
Up to 100% of the Maximum Daily Benefit
 
Lifetime Maximum Benefit
 
Maximum Daily Benefit x Benefit Period
 
Benefit Triggers

(These are the requirements for accessing benefits.)
 
Tax-Qualified Program

Substantial Assistance for 2 of 6 ADLs
or

Chronic Illness (in excess of 90-days)

or
Substantial Supervision due to Severe Cognitive Impairment

Non-Tax-Qualified Program

Nursing Home Facility:


Assistance with 2 of 7 ADLs
or

Cognitive Impairment
or

Physician-certified Medical Necessity

Community-Based Home Care:

Assistance with 1 of 7 ADLs

or
Cognitive Impairment

or
Physician-Certified Medical Necessity

Community-Based Homemaker/Companion Care:

Assistance with 1 of 7 ADLs

or
Assistance with 2 of 7 IADLs
or

Cognitive Impairment

or
Physician-Certified Medical Necessity

 
Care Coordinator Benefit
 
Care Coordinator optional at no charge
 
Bed Reservation Benefit
 
Up to 30 days
 
Caregiver/Family Training Benefit
 
5 x Selected Maximum Daily Benefit
 
Supportive Equipment Benefit
 
$1000 max/year

$5000 max/lifetime
 
Family Member As Caregiver Benefit
 
Up to 100% of Maximum Daily Benefit
 
Respite Care
 
Up to 21 days per calendar year
 
Hospice Care
 
Up to 100% of the Maximum Daily Benefit
 
Coverage Area
 
USA and its possessions
 
Pre-Existing Condition Limitations
 
None, once approved for coverage
 
Waiver of Premium
 

First day after elimination period (60 or 90 days)
requirement has been met for Nursing Home, Assisted Living Facility or Hospice benefits
   

91st day of Home Health Care or Adult Day Care benefits
 
Alternate Care
 

Qualified Long Term Care Services that are
medically acceptable and cost effective; includes medically necessary transportation to/from Adult Day Care
   

Home Modification
 
Payment Options
 

10-Pay:
Premium payments are required during the first 10 years the policy is in force. Once paid, the policy is paid up for your entire life. No further premiums will be required to keep this policy in force.
   

Pay As You Go:
Premium payments are required over the life of the policy to keep the policy in force.
 
Spousal Discount
 
10% off both policies
 
Issue Ages
 
18 - 89
 
Rate Guarantee
 

Under 65 - 10 years



 

65 plus - 5 years
 

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The best benefits in the world are of little value if they can't be accessed. The Long Term Care Program for PERA members and retirees was designed to make it even easier for you to access benefits when you need them:

A Care Coordinator serves as your advocate, helping you access benefits and provides you with information about various long term care providers. YOU make the final choice regarding your care.

Benefits are completely portable, and can be used anywhere in the United States, and its possessions.

Added-value benefits, such as:

Respite Care-
Everyone needs a break once in a while. Your respite care benefit provides temporary relief from caregiving duties for a family member, or another person who is the unpaid primary caregiver. This "time-off" helps your caregiver maintain his/her health and mental well being.

Waiver of Premium-
Once you have met your elimination period requirement (60 or 90 days), premiums are waived on the first day you receive benefits in a Nursing Home, Assisted Living Facility or for Hospice benefits. Premiums are waived on the 91st day of receiving benefits for Home Health Care or Adult Day Care. Premiums will continue to be waived as long as you are receiving care. After all, when you are receiving long term care services, the last thing you want to worry about is insurance bills.

Family Member Training-
Pays expenses (up to five times the maximum daily benefit) for training a family member that does not live with you to provide you with care in your home.

Bed Reservation-
Reserves your bed in the facility for up to thirty (30) days if you become hospitalized during your stay.

Plus, consider the value of these optional features:

 

Lifetime Inflation Protection:
You need to protect your money over time, and inflation protection ensures that your investment keeps pace with the economy for the lifetime of your policy. Inflation protection increases your Maximum Daily Benefit by 5%, compounded every year on the anniversary of the date you purchased the inflation protection, for the lifetime of your policy. The Maximum Lifetime Benefit also increases proportionally. The annual increases will continue to be made even if you are receiving benefits under the policy.

Refund of Premium:
Give a little extra financial protection to your loved ones by purchasing Refund of Premium, which returns a portion of your premiums to your estate if you die before you use all of your benefits.
Nonforfeiture:
Nonforfeiture enables you to keep a portion of the benefits if your policy lapses after having been in force for at least three years. In effect, you get back in benefits what you paid in to the policy.
Spousal Benefit Transfer:
Spousal Benefit Transfer helps protect the financial and emotional well being of you and your spouse because it enables married couples who buy similar coverage to combine their Maximum Lifetime Benefit. That way, when you or your spouse need to access benefits you have the strength of combined coverage backing you - and that strength gives you even more protection when the need for long term care arises. In the event of your death, your surviving spouse's Maximum Lifetime Benefit will be increased by any unused benefits from your policy.
Survivorship:
In the event of your death, your spouse will be protected by the benefits of Survivorship, which enables him/her to continue the policy for the rest of his/her life and waives all renewal premiums. You and your spouse's policies must be in force for ten consecutive years to access this benefit.
Restoration of Benefits:
If you access some or all of your benefits and then do not receive or require care/assistance for a period of 180 consecutive days, you don't have to worry about decreased benefit amounts if you require care some time in the future. With Restoration of Benefits, the Maximum Lifetime Benefit is restored to its original maximum after 180 consecutive days of not receiving care or assistance. There is no limit to the number of times benefits may be restored.
How This Program Works!
Comprehensive long term care offers a flexible benefit account which acts as a pool of money and may be allocated for care at home or in a facility. As you utilize benefits, money is deducted from your pool.

 


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Lifetime Maximum Benefit Periods

3 Years
(1095 Days)

5 Years
(1825 Days)

Unlimited
(Lifetime)


Maximum Daily Benefit Amounts

$100

$130

$180


Elimination Periods

60 Days

90 Days


How to Calculate Your Benefit Amount

Example:
Choose Lifetime Maximum Benefit Period:
Choose Daily Benefit Amount:
Calculate Benefit Pool:
Total Benefit Pool


5 Years (1825 Days)
$130
1825 Days x $130
$237,250




The Long Term Care Program is available to PERA members, retirees, inactive members and eligible family members throughout the United States. The benefits described on this web site pertain to all Colorado residents. Due to individual state requirements, benefits may vary by state. If you are eligible for this coverage and reside outside of Colorado, please call 1-888-PERA-LTC (1-888-737-2582) for more information on the benefits available in your state.

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To order and enrollment kit call Your Benefit Specialists at the toll-free number:
1-888-PERA-LTC (1-888-737-2582)

OR

Click here


U.S. Care, Inc.
3130 Wilshire Boulevard
Santa Monica, CA 91403

Click here to E-mail U.S. Care.

Or visit our website!