Navigating Long-Term Care in Idaho

Idaho participates in the partnership program providing owners of qualified Long-Term Care Insurance dollar-for-dollar asset protection. The state has many qualified care providers available statewide, offering a variety of services.

While many qualified care providers are available throughout Idaho when you need long-term health care, the costs are rising due to the increasing demand for care services throughout the state. 

Some of the available providers include:

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

Several insurance solutions are available to safeguard income and assets from the high costs and burdens of aging. Plus, all tax-qualified Long-Term Care Insurance policies in Idaho have several consumer protections in addition to federal tax benefits.

Federal Partnership Program

The State of Idaho participates in the federal/state partnership program for long-term care. Authorized under federal law in 2005, it provides additional dollar-for-dollar asset protection if you have a qualified partnership long-term care policy.  The Idaho Long-Term Care Partnership Program is a program that involves state government and private insurers. Its purpose is to encourage people to prepare for their future care needs by purchasing insurance that pays when a person requires extended care either at home or in a facility like assisted living or nursing home.

Under the Idaho Long-Term Care Partnership Program, the state will disregard the policyholder’s personal assets equal to the amount paid out under a qualifying insurance policy when determining the person’s eligibility for Medicaid assistance. For example, if a qualifying insurance policy pays out $250,000 in benefits to cover a person’s long-term care needs, Medicaid would not count up to $250,000 of the person’s assets when it determines whether the person is eligible for Medicaid assistance for long-term care costs. This means the person would be able to qualify for long-term care assistance through Medicaid without first having to spend all their personal assets on care. The protected assets will also be exempted from Estate Recovery in the amount equal to the benefits paid by the partnership policy.

Reciprocity

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

Medicaid

Idaho's 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 $3,435.* The home equity limit is $750,000.

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

Idaho Medicaid Estate Recovery Program

When a person applies for the Medicaid program for long-term care services and supports in Idaho, they should understand the state is required to place liens on the home property of Medicaid recipients who receive long-term care services and supports.

Recovery will be for the amount of Medicaid payments made on behalf of the recipient to reimburse the state for the cost of their long-term health care. The estate is subject to the Medicaid Estate Recovery Program, otherwise known as MERP.

Following the death of the care recipient, the deceased's assets are used to reimburse the taxpayers for the long-term health care provided through Medicaid.  

Idaho can place a lien on the estate up to the value of the Medicaid benefits paid. If there is no estate, recovery may be made against the estate of your spouse. Recovery will not be made until after the individual's death and that of a surviving spouse, whichever is later.

The state will recover the cost of long-term care services if assets remain in the estate at the time of death. Idaho is an expanded estate recovery state meaning the state can seek assets that do not go through probate. Expanded recovery means the state can seek reimbursement through assets held by the surviving spouse, life estates, and assets in a living trust.  

Remember that an estate includes all real and personal property (homes, land, vehicles, cash, bank accounts) held individually or jointly. All deceased assets are subject to recovery, including holdings in most trusts.

Idaho can place a lien on real estate. Also, it is essential to note that a penalty might be applied if there was a transfer of real or personal property without adequate consideration, meaning for less than fair market value.

The state may "look back" up to 60 months before application for Medicaid long-term care services to determine when income was reduced and resources were transferred.

Remember, Idaho's Medicaid program 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 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 Idaho

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

• Idaho Area Agencies on Aging (ICOA) - 208-334-3833

The ICOA assists older adults and those with disabilities to remain independent, avoid institutionalization, and age in place in their own homes and communities of choice.

The state has five AAAs serving different regions of the state, helping residents and their families with advocacy, referrals, and services.

• Idaho Adult Protective Services - 866-654-3219

Their role is to protect seniors and vulnerable adults in Idaho from abuse, neglect, or exploitation. Adult Protective Services (APS) responds to the following reports of abuse, neglect by others or from self-neglect, and financial exploitation. 

If the situation is very serious, threatening, or dangerous, APS recommends calling 911 or local police for immediate help.

• Idaho Long-Term Care Ombudsman - 208-334-3833

The Ombudsman investigates alleged neglect or abuse allegations and provides consultations for Idaho seniors and their families concerned about their long-term health care quality and safety. 

The Idaho Long-Term Care Ombudsman provides advocacy services to residents of long-term care facilities, including nursing homes. 

At least one time per quarter, an Ombudsman visits each long-term care facility to inspect quality and safety. 

• Idaho Commission on Aging - 800-926-2588

The Idaho Commission on Aging is a single point of contact for seniors and their families seeking aging-related services through the Aging and Disability Resource Center. The ADRC can give information on community-based services that support seniors age at home and advocacy and referral services to those seniors who choose to pursue long-term care. 

• Senior Health Insurance Benefit Advisors SHIBA - 800-247-4422

SHIBA serves Idahoans on Medicare and their loved ones by offering free and unbiased Medicare benefits information and assistance through workshops, group presentations, and personal counseling.

Rate Stability Rules

In addition, Idaho 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 Idaho

There are several products approved in Idaho for Long-Term Care planning. These include traditional plans, including partnership certified policies, short-duration policies, and asset-based “hybrid” plans.

Tax Incentives

There are state tax incentives available. Premiums paid for LTC insurance during the taxable year, when the LTC insurance is to be for the benefit of the taxpayer, a dependent of the taxpayer, or an employee of the taxpayer, may be deducted from taxable income to the extent that the premium is not otherwise deducted or accounted for by the taxpayer for Idaho income tax purposes. The deduction may be taken for a federally tax-qualified LTC insurance policy meeting Idaho’s definition of LTC insurance. Federal tax incentives also apply.

Reverse Mortgages in Idaho

Reverse mortgages are available in Idaho. A reverse mortgage is a home equity loan where the borrower does not have to make payments.

This type of mortgage can increase monthly income, eliminate mortgage payments, and even fund Long-Term Care Insurance. However, Idaho has many rules on these products, and you should seek the help of a qualified and licensed mortgage broker. 

If you have significant equity in your home and you and your spouse are at least 62 years old, you can get a reverse mortgage to turn your equity into funding long-term health care, pay for an LTC Insurance policy, pay bills and add to your retirement lifestyle.

The home must be the principal residence without any tax liens. 

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.}