Navigating Long-Term Care in Delaware

Delaware participates in the long-term care partnership program providing owners of qualified LTC Insurance policies dollar-for-dollar asset protection from future extended health care costs. There are also tax incentives available.

Quality care options are available statewide, and several insurance solutions are available. However, rapidly increasing costs for care services throughout Delaware are becoming burdensome on residents and their families for those who do not have Long-Term Care Insurance.

The variety of quality care options available in Delaware for those who require long-term health care services include:

• adult day care centers
• assisted living facilities
• continuing care retirement communities
• home health care providers
• memory care facilities
• rehabilitation facilities
• traditional nursing homes

Top insurance companies have several insurance options to help residents safeguard income and assets, protect lifestyles, and preserve a legacy. Plus, policyholders will have access to quality care options giving loved ones the time to be family instead of caregivers.

Federal Partnership Program

Delaware participates in the federal/state partnership program as of November of 2011. A Delaware Partnership Long-Term Care insurance policy provides you with additional asset protection as authorized under the federal Deficit Reduction Act (DRA). If you spend down all the money in your qualified LTC policy you will have the ability to apply for Medicaid under modified eligibility rules that include a special feature called an ‘asset disregard’ or “dollar-for-dollar” asset protection.

The policy must meet state guidelines and have the appropriate inflation protection as required by law. The state will not attempt to recover any money from the estate equal to the amount of benefits protected under your partnership long-term care policy.

Policy Example

The asset protection is equal to the amount of benefits paid by the policy. For example, your Delaware Long-Term Care Partnership policy pays out $480,000 in benefits when you exhaust benefit, however, you are still living and require long-term care services. The state disregards that same amount in the calculation for the Medicaid Long-Term Care benefit. This way you are able to keep a much larger amount of assets then you would otherwise be allowed to keep and still qualify for Medicaid. The Partnership Program also protects those assets after death from Medicaid estate recovery.

Reciprocity

Most states have reciprocity with other states' long-term-care partnership programs including Delaware. This means if you move from or to Delaware your partnership asset protection follows you as well.

Medicaid

Diamond State Health Plan – Plus (DSHP-Plus) is the Medicaid program for long-term care services and supports in Delaware. The Medicaid program will pay for long-term health care if an individual has little or no income and assets. The Long-Term Care Medicaid spend down is $2,000. A spouse’s minimum asset allowance is a minimum of $27,480 up to a maximum of one-half of countable assets up to $137,400.  Your spouse’s minimum monthly income allowance is $2,177.55 * The home equity limit is $636,000.

For more information about the Medicaid program visit  www.medicaid.gov

Delaware Medicaid Estate Recovery Program

When a person applies for the Diamond State Health Plan – Plus (DSHP-Plus, the Medicaid program for long-term care services and supports in Delaware, they are notified of the Medicaid estate recovery program during their initial application for eligibility. The estate will be subject to the Medicaid Estate Recovery Program, otherwise known as MERP.

The state will recover the cost of long-term care services if assets remain in the estate at the time of death. Assets subject to recovery during probate will include your home and other real estate, bank accounts, other financial assets, vehicles, cash, and even household goods. Certain assets in trusts are also subject to recovery. 

Remember, Medicaid (DSHP-Plus - the Medicaid program in Delaware) will provide long-term care services only if you have little or no income and assets. However, the state will never require a living spouse to move out of their home. 

If the deceased does not own assets when they die, there will be nothing to recover.

Recovery is limited to an estate whose assets are subject to probate and owned by the deceased at the time of death. The state may "look back" up to 60 months before application for DSHP-Plus long-term care services to determine when income was reduced and resources were transferred.

If a person had a qualified Partnership Long-Term Care Insurance policy, the total amount of benefits paid by the policy would be sheltered from asset recovery. 

State Resources for Aging and Long-Term Care in Delaware

There are a variety of state resources available in Delaware to help residents and their families with issues of aging and long-term health care. Many of these services benefit low-income families. 

• Delaware Aging and Disability Resource Center - 800-223-9074

This agency is a one-stop resource providing residents and their families 

with information on age-related programs and services. The Delaware Aging and Disability Resource Center (ADRC) assists with personal care services, home-delivered meals, emergency response systems, and respite care. 

The ADRC helps residences and their loved ones understand their available options and help families decide which services best meet the individual's needs. The office will also help the care recipient obtain the appropriate services and supports that meet their needs and preferences. 

The Delaware Long-Term Care Ombudsman's office is available through the ADRC. The Ombudsman's office advocates for Delaware residents who live in long-term care facilities and those who live in other settings (including their own homes). 

The Ombudsman's office will investigate the concerns and complaints from the residents of long-term care facilities or their families regarding violations of resident rights. The office will also advocate for improving the quality of life for residents living in long-term care facilities.  

• Delaware Division of Services for Aging and Adults with Physical Disabilities - 800-223-9074

This agency offers a variety of services for seniors and caregivers alike. The Delaware Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) provides the necessary information to help those needing long-term health care services find the resources they need. The DSAAPD provides referrals, including home- and community-based services that allow older adults to stay in their own home and delay or avoid the need for a long-term care facility. 

The agency also offers a Nursing Home Transition program for DSHP-Plus (the Medicaid program in Delaware) eligible residents assisting them to return to the community.

• Meals on Wheels Delaware (302) 656-3257

There are five regional Meals on Wheels programs in Delaware that deliver nearly 900,000 meals to more than 6,200 homebound seniors and disabled adults every year. 

• Delaware Medicare Assistance Bureau (800) 336-9500 T

The Delaware Medicare Assistance Bureau (DMAB), formerly known as ELDERinfo, provides free health insurance counseling for people with Medicare.

The agency helps people understand their options and make the best decisions related to Medicare, Medicaid, Medigap (Medicare supplement insurance), Medicare Part D, Long-Term Care Insurance, and other types of health insurance. There is no charge for the service.

The DMAB is a free resource available to all Medicare beneficiaries and new enrollees.  

Rate Stability Rules

In addition, Delaware consumers enjoy additional peace-of-mind as the state has adopted Long-Term Care Insurance Rate Stability Rules.  These rules, developed the National Association of Insurance Commissioners, makes it much harder for an insurance company to get an approved rate increase.

Products Approved in Delaware

A variety of affordable products are approved in Delaware for Long-Term Care planning. These include traditional plans (including partnership certified policies), short-duration plans and asset-based “hybrid” plans.

Tax Incentives

There are no current state tax incentives available at this time, federal tax incentives do apply.

Reverse Mortgages in Delaware

Reverse Mortgages are not like traditional ones, but they can be an important option for some people. In Delaware, residents use reverse mortgages to help them in retirement to provide income, fund LTC Insurance or even fund long-term care services at home. 

A reverse mortgage is a loan that you don't have to pay back - or make payments on as long as you are still living. 

You must be at least 62 years old, and at least one owner must live in the house most of the year. Eligible homes include single-family dwellings, two to four-unit, owner-occupied dwellings, and some condominiums and manufactured homes. 

By law, you can never owe more than your home's value when the loan is repaid. So, in the event your home loses value, you are protected. You don't make mortgage payments, but you still must pay the property taxes, insurance and properly maintain the residence.

Learn more about reverse mortgages by clicking here.

_{*The federal government sets a new minimum and maximum amounts each year, but states can set their own minimum requirements at any level between the federal limits. This information is based on the best available sources}