The Pennsylvania Insurance Department oversees long-term-care insurance in the Commonwealth, setting policy standards and consumer-disclosure requirements. Its consumer guide frames insurance as a private coverage decision that should be measured against a policy's actual terms and a family's own situation — not treated as a given.
Long-term-care insurance sits apart from Medical Assistance eligibility, but a qualifying Partnership policy can still affect how resources are counted if Medicaid ends up being needed down the line.
Does Pennsylvania have a Long-Term Care Partnership program?
Yes. Pennsylvania takes part in the Long-Term Care Partnership program created by the federal Deficit Reduction Act of 2005 (DRA). DRA Partnership states follow consumer-protection standards drawn from the National Association of Insurance Commissioners (NAIC) Long-Term Care Insurance Model Act and Model Regulation. A Partnership-qualified policy gives you dollar-for-dollar asset protection: for every dollar the policy pays in benefits, Pennsylvania Medicaid can disregard a dollar of your assets when it decides eligibility, and the same amount is protected from estate recovery after death.
How the protection works (illustrative): if a Partnership policy pays $200,000 in benefits before you apply for Medicaid, Medicaid can disregard $200,000 of your assets on top of the state's regular asset limit, and that same amount is protected from Medicaid estate recovery later.
What makes a policy Partnership-qualified
- It's a tax-qualified long-term care policy under Internal Revenue Code § 7702B.
- It meets the state's Partnership consumer-protection standards and is issued while you're a resident of a Partnership state (each state sets its own start date and residency rule).
- It carries the required inflation protection for your age when you buy: compound annual protection if you're under 61, some level of protection from 61 through 75, and optional protection at 76 or older.
If you move to another state
Pennsylvania appears on the New York State Partnership for Long-Term Care's reciprocity map as a Partnership state that honors reciprocity. In general, a Partnership policy bought in another reciprocal state keeps its dollar-for-dollar protection here, and a Pennsylvania policy keeps it in other reciprocal states.
The original four: California, Connecticut, Indiana and New York started their Partnership programs before the Deficit Reduction Act of 2005. Their programs were designed separately from the NAIC-based DRA model, so their rules differ (for example, some offered Total Asset protection), and California doesn't take part in reciprocity. If you bought a policy in one of these states, confirm how it's treated with the Medicaid agency where you'll apply.
Not every insurer offers Partnership-qualified policies in every state. When you compare quotes, ask whether each policy is Partnership-qualified in Pennsylvania.
Sources and official resources
- Pennsylvania Insurance Department: Long-Term Care
- Pennsylvania DHS: Medicaid and Payment of Long-Term Services
- New York State Partnership for Long-Term Care: State Partnership Programs and Reciprocity map
- U.S. Code: 42 U.S.C. § 1396p (liens, estate recovery, transfers of assets, Partnership disregard)
Rules and figures change. Confirm current details with the agency before you act.