Many people mistakenly believe government programs, like Medicare and Medicaid, will provide all the long-term care services they need. Unfortunately, this may not be the case. Failing to plan how you’ll pay for long-term care services may place you at serious financial risk.


Medicare generally does not pay for long-term care services. Instead, it’s designed to help get you back on your feet following an illness or injury.

  • Medicare pays only for “skilled care” you receive in a nursing home, but only if it’s medically necessary and only for a limited period of time
  • Medicare does not pay for “custodial care” services many people receive in their homes – services like assistance with dressing, bathing and using the bathroom. Medicare also does not pay for care received in an assisted living facility


Medicaid provides long-term care assistance to individuals who have exhausted their personal resources.

  • Medicaid pays for both “skilled care” and “custodial care” received in a nursing home, but only after you spend down your assets to meet eligibility guidelines in your state
  • In some states, Medicaid may pay for some services received at home or in an assisted living facility

What is a long-term care partnership program?

It’s a partnership between your state government and private insurance companies. Insurance companies voluntarily agree to participate by offering long-term care insurance policies that meet specified criteria. The state agrees to provide Medicaid asset protection to people who purchase partnership-qualified policies.

How does Medicaid asset protection work?
When you purchase an individual long-term care insurance policy that meets your state’s guidelines, you will be allowed to protect a portion of the assets you might otherwise have to “spend down” in order to meet Medicaid eligibility requirements. This allows you to protect one dollar of personal assets for each dollar your long-term care insurance policy pays in benefits. For example, if you purchase a long-term care insurance policy that pays $100,000 in benefits, you will be allowed to protect $100,000 in personal assets. This is above and beyond the assets you are allowed to keep in order to qualify for Medicaid.

When you need long-term care services, your long-term care insurance policy will pay for your care. In the event that you receive long-term care benefits through your state’s Medicaid program, your partnership qualified long-term care policy will enable you to protect some or all of your assets.

What’s the benefit of purchasing a partnership-qualified long-term care insurance policy?

Purchasing a partnership-qualified long-term care insurance policy can help you to assume responsibility for your long-term care needs and control what happens to you in the future. If you eventually apply for Medicaid, it allows you to protect a portion of your assets from Medicaid “spend down” so they can be passed on to your heirs. And even if you don’t plan to apply for Medicaid benefits, it may help provide peace of mind knowing you have that safety net.

SB&K Benefits, LLC can help you design a Long Term Care Policy that meets your needs, and Texas offers a Partnership Long Term Care program. Contact us for a consultation – 832-482-2494 or email us through this website.