Form LTC-7 "Missouri's Long-Term Care Insurance Partnership Delivery Notice" - Missouri

What Is Form LTC-7?

This is a legal form that was released by the Missouri Department of Commerce and Insurance - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 10, 2008;
  • The latest edition provided by the Missouri Department of Commerce and Insurance;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form LTC-7 by clicking the link below or browse more documents and templates provided by the Missouri Department of Commerce and Insurance.

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Download Form LTC-7 "Missouri's Long-Term Care Insurance Partnership Delivery Notice" - Missouri

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[Date
Company name
Address
Contact information
Other company identifiers
Insured’s name
Address
Insured’s policy/certificate number
Effective date/policy issue date]
“Missouri’s Long-Term Care Insurance Partnership
Delivery Notice”
Important Information Regarding Your [Policy’s] [Certificate’s] Long-
Term Care Insurance Partnership Status
Note: Please keep a copy of this notice
Partnership policy status.
Insurance companies can voluntarily agree to participate in the Missouri
long-term care insurance partnership program by offering long-term care
insurance policies that meet certain state and federal requirements
(partnership plan). Our company has chosen to participate in this program.
Therefore, the long-term care insurance [policy] [certificate] you have
purchased qualifies as a partnership plan.
What does this mean to you?
Under the partnership program, if you own a long-term care insurance
[policy] [certificate] that qualifies as a partnership plan, you may be able to
protect some of your assets from Medicaid’s “spend down” requirements if
you should ever have to apply for Medicaid benefits. For example, if you
have a [policy] [certificate] that qualifies as a partnership plan, you may be
able to shield one dollar of your assets under Medicaid for every dollar of
benefits the policy pays for your long-term care. Please note that the
purchase of a partnership plan does not automatically qualify you to
receive benefits under Medicaid. Medicaid has certain requirements that
must be met in order to receive benefits under a state Medicaid program.
[Date
Company name
Address
Contact information
Other company identifiers
Insured’s name
Address
Insured’s policy/certificate number
Effective date/policy issue date]
“Missouri’s Long-Term Care Insurance Partnership
Delivery Notice”
Important Information Regarding Your [Policy’s] [Certificate’s] Long-
Term Care Insurance Partnership Status
Note: Please keep a copy of this notice
Partnership policy status.
Insurance companies can voluntarily agree to participate in the Missouri
long-term care insurance partnership program by offering long-term care
insurance policies that meet certain state and federal requirements
(partnership plan). Our company has chosen to participate in this program.
Therefore, the long-term care insurance [policy] [certificate] you have
purchased qualifies as a partnership plan.
What does this mean to you?
Under the partnership program, if you own a long-term care insurance
[policy] [certificate] that qualifies as a partnership plan, you may be able to
protect some of your assets from Medicaid’s “spend down” requirements if
you should ever have to apply for Medicaid benefits. For example, if you
have a [policy] [certificate] that qualifies as a partnership plan, you may be
able to shield one dollar of your assets under Medicaid for every dollar of
benefits the policy pays for your long-term care. Please note that the
purchase of a partnership plan does not automatically qualify you to
receive benefits under Medicaid. Medicaid has certain requirements that
must be met in order to receive benefits under a state Medicaid program.
What could disqualify a plan as a partnership plan?
If any changes are made to the plan once it has been purchased, these
changes could affect whether the plan will continue to be qualified as a
partnership plan. Therefore, if you have purchased a partnership plan, before
you make any change to the plan (e.g., decrease the level of benefits), you
should consult with us to determine the effect of the proposed change. In
addition, if you should move to a state that does not maintain a partnership
program or does not recognize the policy as a qualified partnership plan
under the laws of that state, any payment of long-term care benefits under
the policy would not protect your assets under the Medicaid program.
State and federal law governing partnership plan policies
The information contained in this notice is based on current Missouri and
federal laws. However, please be aware that these laws are subject to change
at any time in the future, which changes could result in the modification,
reduction or even the elimination of the Medicaid-asset protection feature.
Questions?
Should you have questions regarding the long-term care insurance
partnership program [policy] [certificate] you have purchased, please contact
____________at______________________.
If you have questions about Missouri’s long-term care partnership program
or questions about long-term care insurance in general, please call the
Missouri Department of Insurance, Financial Institutions & Professional
Registration at 1-800-726-7390. You may also access more information at
the following web sites.
http://www.difp.mo.gov
http://www.dss.mo.gov
[Company’s web site]
Form LTC-7
(Rev 3/10/2008)
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